婴幼儿呼吸道异物临床与多层螺旋CT表现分析  

Analysis of clinical performance and multislice spiral CT findings in infants with aspirated foreign body

作　　者：梁明玉 梁永晴 王钟灵[1] 黄俊毅[1] 李光明[1] LIANG Mingyu;LIANG Yongqing;WANG Zhongling;HUANG Junyi;LI Guangming(Department of PET/CT Center,The Sixth Affiliated Hospital of Guangzhou Medical Universitity,Qingyuan People’s Hospital,Qingyuan 511518,P.R.China)

机构地区：[1]广州医科大学附属第六医院,清远市人民医院PET/CT中心,广东清远511518

出　　处：《医学影像学杂志》2020年第9期1644-1647,共4页Journal of Medical Imaging

摘　　要：目的探讨婴幼儿呼吸道异物多层螺旋CT的表现,提高本病的诊断准确性。方法选取我院有完整临床和CT影像资料的患儿52例,回顾性分析其临床和CT表现。结果52例中误吸史40例(76.9%,40/52),咳嗽或呛咳44例(84.6%,44/52),咳痰33例(63.5%,33/52)。异物类型主要是果仁、果核等食物类。异物位于气管7例(13.5%,7/52),右侧支气管29例(55.8%,29/52),左侧支气管16例(30.8%,16/52)。39例患儿出现并发症,其中阻塞性肺气肿34例(65.4%,34/52),阻塞性肺炎13例(25.0%,13/52),纵隔移位9例(17.3%,9/52),阻塞性肺不张2例(3.8%,2/52),颈部纵隔气肿1例(1.9%,1/52)。不同异物位置(P<0.001)、不同起病时间(P=0.028)发生阻塞性肺气肿差异有统计学意义。结论结合异物吸入史,气道异物直接和间接CT征象可减少误诊;沿可疑异物所在气道走行方向重建是准确诊治气道异物的有效方法。Objective To improve the diagnosis accuracy of infants’foreign bodies aspiration by exploring its MSCT performance.Methods 52 cases with clinical and MSCT data were collected and analyzed retrospectively.Results Among the 52 patients,40 had a history of aspiration(76.9%,40/52),and 44 had cough or bucking(84.6%,44/52),33 were coughing up sputum(63.5%,33/52).Most of foreign bodies were food such as nuts,kernels and so on.7 cases of foreign bodies were detected in trachea.29 cases were found in right bronchus while 16 cases were in the left side.39 patients suffered from complications,including 34 cases of obstructive emphysema(65.4%,34/52),13 cases of obstructive pneumonia(25.0%,13/52),9 cases of mediastinal shift(17.3%,9/52),2 cases of obstructive atelectasis(3.8%,2/52)and 1 case of neck mediastinal emphysema(1.9%,1/52).In terms of different foreign body locations(P<0.001)and different onset time(P=0.028),there were statistically significant differences in the incidences of obstructive emphysema.Conclusion One way of reducing misdiagnosis is to combine a history of foreign body inhalation with direct and indirect signs of foreign bodies.Reconstructing along the bronchia could help to improve the diagnosis accuracy and treatment of foreign bodies.

关 键 词：呼吸道异物 婴幼儿 体层摄影术 X线计算机 

分 类 号：R725.6[医药卫生—儿科] R814.42[医药卫生—临床医学]