论文部分内容阅读
目的：评价儿童气道透Ｘ线异物吸入的临床特征和Ｘ线检查的诊断价值及限度。材料与方法：回顾性分析１９８７～１９９７年１９８例，８１．３％为３岁以下婴幼儿。全部病例经Ｘ线透视，１５２例摄有呼、吸二相胸片，均经内窥镜、气管切开或咯出异物证实。结果：（１）异物多数（８９．４％）为食物，半数以上（５７．６％）为花生。２１例（１０．６％）无机物中以笔帽为多（５７．１％）。（２）楔形和球形异物远较异形异物容易引起肺不张（Ｐ＜０．００１）。吸入时间越久，肺气肿越少，但越易发生肺不张、纵隔移位或摆动和并发肺炎（Ｐ＜０．０５、＜０．０１、＜０．０５、＜０．００１）。时间越短暂心影吸气性增大越多见（Ｐ＜０．００１）。（３）Ｘ线透视诊断准确性为９５．９％，各部位定位准确性为７０．０％～９１．４％。（４）Ｘ线表现以纵隔移位或摆动最多见（６９．１％），主要见于单侧支气管异物（９１．４％）。７０．５％喉、气管异物和４０．０％复合部位异物有心影吸气性增大。结论：（１）异物的气流效应决定Ｘ线表现，并取决于异物的形态、大小及与气道的匹配关系。（２）Ｘ线检查对异物的发现和定位起重要作用，观察纵隔改变透视远较平片优越。（３）强调对强烈提示异物吸入而?
Objective: To evaluate the clinical characteristics of X-ray foreign body aspiration and the diagnostic value and limits of X-ray examination in children. Materials and Methods: A retrospective analysis of 198 cases from 1987 to 1997, 81.3% of infants under 3 years of age. X-ray fluoroscopy of all cases, 152 cases of call, sucking two-phase chest radiographs were confirmed by endoscopy, tracheotomy or a foreign body. Results: (1) Most foreign bodies (89.4%) were food, and more than half (57.6%) were peanuts. In 21 cases (10.6%) inorganic substances in the pen cap as much (57.1%). (2) Wedge and spherical foreign bodies are more likely to cause atelectasis than abnormal ones (P <0.001). The longer the inhalation time, the less emphysema, but the more prone to atelectasis, mediastinal shift or swing and pneumonia (P <0.05, <0.01, <0.05, <0.001). The shorter the time, the more likely to increase aspiration (P <0.001). (3) The diagnostic accuracy of X-ray is 95.9%, and the accuracy of positioning of each part is 70.0% -91.4%. (4) X-ray showed the most common mediastinal shift or swing (69.1%), mainly in unilateral bronchial foreign body (91.4%). 70.5% throat, tracheal foreign bodies and 40.0% compound foreign body have heart shadow inspiratory increased. Conclusion: (1) The airflow effect of foreign body determines the X-ray performance, and depends on the foreign body morphology, size and matching with the airway. (2) X-ray examination on the discovery and localization of foreign bodies play an important role in the observation of mediastinal changes far better than the plain. (3) Emphasize the strong reminder of foreign body aspiration?