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目的回顾文献报道的牙科操作中的误吸误咽病例,探讨总结误吸误咽的治疗与预防措施。方法针对关键词“dental procedure/treatment/practice”、“aspiration/inhalation”和“ingestion/swallow”进行2014-10-01前的文献检索。对发表期刊、时间,患者性别、年龄、全身状况,所进行的牙科操作、操作场所,异物种类、累及部位,出现误吸误咽的可能原因、出现后症状,治疗时间、方法,以及随访结果等进行系统回顾性分析。结果 38本期刊的46篇文章报道病例628例,分析数据显示,60~79岁和10~19岁是发生误吸误咽最多的年龄段。只有12例报道患有系统性疾病,种植和修复治疗时发生例数最多,根管锉、种植体螺丝及其扳手是最多见异物,多累及支气管或胃内。只有1/3病例报道了原因。发生意外后,约1/2误吸病例和少数误咽病例出现了症状。大多数误吸病例和约1/2误咽病例通过内镜介入方法取出异物,只有1例误吸病例在异物取出后出现急性呼吸梗阻。结论尽管牙科操作中发生误吸误咽非常少见,但每一位牙科医护人员都应该重视预防和治疗,避免和减少意外发生。
Objective To review the cases of aspiration and mistreatment in dental operations reported in the literature and to discuss the treatment and prevention measures of aspiration and misdiagnosis. Methods The literature search prior to 2014-10-01 was performed for the keywords “dental procedure / treatment / practice”, “aspiration / inhalation” and “ingestion / swallow”. The possible causes of postoperative jaundice and misdiagnosis, symptoms after presentation, duration of treatment, methods, and follow-up results of published journals, time, patient’s sex, age, general condition, dental operations performed, site of operation, types of foreign bodies, Systemic retrospective analysis. RESULTS: Forty-six articles in this issue reported 628 cases. Analytical data showed that 60-79 years old and 10-19 years old were the most likely to have aspiration and aspiration. Only 12 cases were reported with systemic diseases. The most cases occurred when implanting and repairing the treatment. The root canal files, implant screws and their wrenches were the most common foreign bodies, involving the bronchial or stomach. Only one third of the cases reported the cause. After an accident, about 1/2 cases of aspiration and a few cases of paroxysmal eyestrain symptoms. Most cases of aspiration and about 1/2 of cases of parapharyngeal removal of foreign body by endoscopic intervention, only 1 case of aspiration in the removal of foreign body after acute respiratory obstruction. Conclusions Despite the rare occurrence of misdiagnoses and mistakes in dental procedures, every dentist should pay attention to prevention and treatment to avoid and reduce accidents.