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目的探讨儿童支气管特型异物手术治疗时机和术式。方法回顾分析手术治疗22例儿童支气管异物的临床资料,男16例,女6例;年龄3～12岁。其中植物类异物13例、金属类异物3例、其他异物6例。结果急诊手术3例,择期手术19例。17例行支气管切开取异物并成形术,4例行肺叶切除术,1例经胸取异物失败。术后并发肺不张2例,切口感染1例,呼吸功能不全1例。经处理治愈;多脏器功能衰竭死亡1例。结论经内镜取异物失败不伴致命性并发症者尽可能避免急诊手术,术前应明确定性、定位;对长期药物治疗效果不佳的肺化脓症、肺不张应考虑支气管异物的可能。
Objective To investigate the timing and operation of children bronchial special foreign body surgery. Methods The clinical data of 22 children with bronchial foreign bodies surgically treated were retrospectively analyzed. There were 16 males and 6 females, aged 3 to 12 years old. Among them, 13 were plant-based foreign bodies, 3 were metallic foreign bodies, and 6 were other foreign bodies. Results Emergency surgery in 3 cases, elective surgery in 19 cases. Twenty-seven patients underwent bronchotomy with angioplasty, 4 underwent lobectomy, and 1 underwent thoracotomy. Postoperative pulmonary atelectasis in 2 cases, incision infection in 1 case, respiratory insufficiency in 1 case. Treatment was cured; multiple organ failure in 1 case. Conclusion The failure of endoscopic fetus with non-fatal complications of failure to avoid emergency surgery, surgery should be clearly defined, positioning; long-term drug treatment of pulmonary empyema, atelectasis should consider the possibility of bronchial foreign body.