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小儿支气管异物在临床上并非少见,有明显异物史容易诊断,而异物史不清,且为能透过X线者,诊断困难,往往误诊为支气管炎、肺炎、肺不张.现将我们遇到的14例报告如下.1 临床资料本组14例,男9例,女5例,年龄3岁～12岁,异物存留时间1个月～3年余、异物种类有豆类、花生米、橡皮塞、玻璃珠、牙齿:铆钉、圆珠笔帽、狗尾巴草等.2 典型病例例1:患者女,7岁.因咳嗽、发热反复1年余,经常在儿科门诊及他院就诊,胸透报告右中叶肺不张,诊断为支气管炎、肺不张,经治疗后缓解,不久又复发.此次复诊胸片报告正位片右心缘重叠处有一铆钉样金属异物,侧位片相当于中叶支气管开口处.为支气管内异物伴右中叶肺不张.追问病史病前曾误吞铆钉1枚.例2:患者女,11岁.因反复咳嗽,发热2个月,加重6天来院就诊.半个月前胸透报告右下肺不张,抗炎治疗半月后症状减轻,此次门诊胸片报告:右心缘旁相当于下叶支气管开口处可见0.6×0.5cm大小致密影为右下叶支气管异物伴肺不张.追问病史2个月
Pediatric bronchial foreign body is not uncommon in clinical, there is a clear history of foreign body easy to diagnose, and foreign body history is not clear, and to be through the X-ray, the diagnosis is difficult, often misdiagnosed as bronchitis, pneumonia, atelectasis. To 14 cases reported as follows.1 Clinical data The group of 14 patients, 9 males and 5 females, aged 3 to 12 years old, foreign body retention time of 1 month to 3 years, the foreign species are beans, peanuts, Rubber case, glass beads, teeth: rivets, ball cap, dog tail grass, etc. 2 typical cases Case 1: female patient, aged 7. Due to cough, fever repeated more than 1 year, often in pediatric clinic and his hospital, The report of the right middle of the lung atelectasis, diagnosis of bronchitis, atelectasis, remission after treatment, and soon relapse .This referral chest radiographs right heart edge overlap a rivets-like metal foreign body, the lateral film equivalent Middle of the bronchial opening at the end of the bronchial foreign body with atelectasis of the right middle of the leaflet. Asked the history of the disease had swallowed a rifle before .Example 2: female patient, 11 years old .Because of repeated cough, fever for 2 months, increased 6 days to the hospital Half a month ago, chest X-ray report of the right lower lung atelectasis, anti-inflammatory treatment after half a month to reduce the symptoms, the chest X-ray Report: Right next to the equivalent of lower lobe bronchus Xinyuan visible through opening 0.6 × 0.5cm size opacities for the right lower lobe bronchus with atelectasis questioning history two months.