摘要
目的气管支气管异物（TFBs）吸入可发生在各个年龄阶段，而成人TFBs报道较少。本研究报道了我国中南地区的成人TFBs的危险因素、特点及应用支气管镜取异物的经验。方法我们回顾性检索了1997年1月至2012年2月14岁以上的气管支气管异物患者，分析其发病率、危险因素、临床表现、影像学特点，以及异物种类和异物部位。结果在27719例行支气管镜检查的患者中有244（0．88％）例发现了TFBs。50岁以上的患者，年龄越大，发病率越高；70-80岁年龄段发病率达0．62％。仅在32例（6．6％）患者发现了脑血管疾病和神经退行性疾病等危险因素。在153例有明确异物吸入史的患者中，135例（88．2％）的异物吸入与食用了辣椒且饮食时大声交谈有关。最常见的临床表现为阵发性咳嗽（81．1％）。胸部X线片发现不透光异物的仅有12例（4．9％），而胸部CT发现不透X线的异物有106例（43．4％）。最常见的间接胸部影像学表现为同一部位反复的肺部感染或实变（34．4％）。最常见的异物种类为动物骨头碎片（47．2％）。异物最常见的定位是在右侧支气管（65．6％），可曲式支气管镜成功取出异物234例（95．9％）。结论虽然TFBs在中国南方地区的成年人中并不常见，但其支气管镜发现率（0．88％）明显高于西方的报道（0．32％-0．33％），饮食嗜好辣椒和饮食时大声交谈可能是我国中南地区高发病率的主要危险因素。
Objective Tracheobronchial foreign bodies （TFBs） aspiration is rare in adults, although it can occur at any age. This study aimed to report our experience in airway foreign body removal by flexible bronchoscopy in adult patients of central south China. Methods A total of 244 patients with TFBs over the age of 14 years were reviewed retrospectively from January 1997 to February 2012. The incidence, risk factors, clinical manifestations,radiological findings, types and locations of TFBs were analyzed. Results Among the 27719 patients,TFBs were found only in 0. 88% （244） cases. The prevalence of TFB aspiration increased steadily with age beginning in the fifth decade. The incidence of TFBs was 0. 62% among people aged 70 to 80 years. Risk factors such as cerebrovascular diseases and neural degenerative disease were found among 32 （6.6%） patients. Among 153 patients with clear history of foreign body aspiration, 135 patients （88. 2% ） were addicted to the hot pepper. Paroxysmal cough （81.1%） was the most common clinical manifestations of TFBs. Only 12 cases （4. 9% ） were found with non-opaque foreign bodies by chest X-ray but 106 cases （43.4%） were found with opaque foreign bodies by chest CT. The most common indirect chest imaging findings were recurrent infections and consolidation of the same area. Bone fragments of animals was the most common type in foreign bodies （47. 2% ）. The most common position of foreign bodies was the right bronchial （65.6%）. Total foreign bodies of 234 patients （95.9%） had been successfully removed by flexible bronchoscopy. Conclusions Although TFBs is rare in adults in south China, but yield by flexible bronchoscopy （0. 88% ） is much higher than that is reported in western countries （0. 32%-0. 33% ）. Addiction to the hot pepper and speaking loudly when having dinner may be the major risk factor for high incidence in central south China.
出处
《中国呼吸与危重监护杂志》
CAS
2014年第1期72-77,共6页
Chinese Journal of Respiratory and Critical Care Medicine
关键词
气管支气管异物
可曲式支气管镜
辣椒
Tracheobronchial foreign body
Flexible bronchoscopy
Hot pepper
