广西综合医院气管支气管异物15年病例回顾
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广西医科大学第一附属医院

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Tracheobronchial foreign bodies in general hospital of Guangxi: A 15-years’ review study
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First Affiliated Hospital,Guangxi Medical University

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    摘要:

    目的:回顾分析广西医科大学第一附属医院近15年来不同科室收治的气管支气管异物病例的临床特点,探寻气管支气管异物诊治趋势,为气管支气管异物的诊治提供临床经验与参考。方法:收集并整理2005年1月至 2019年12月期间在我院耳鼻咽喉头颈外科、儿科、呼吸内科及其他科室诊断为气管支气管异物的病例资料,总结比较不同阶段、不同科室气管支气管异物病例的诊断治疗特点。结果:(1)本研究共收集了699例气管支气管异物病例,其中耳鼻喉科549例(78.5%),儿科70例(10%),呼吸内科65例(9.3%),其他科15例(2.1%)。在第一个5年阶段中,患者以耳鼻喉科收治为主(90.1%);至2019年,儿科和呼吸内科收治病例比例增至56.10%,P=0.000。纤维支气管镜的应用比例由2012年的6.30%增至2019年的61.00%。(2)影像检查方式包括胸部X线253例(36.2%)、胸部CT404例(57.8%)、胸部X线检出率为71.1%,胸部CT检出率为91.3%,P=0.000。(3)耳鼻喉科、儿科、呼吸内科及其他科15年总的平均住院日分别为3.68天、6.89天、11.00天,P=0.000。(4)手术相关并发症发生率为3.4%(24/699),其中耳鼻喉科、儿科、呼吸内科、其他科分别为1.8%(10/549)、8.6%(6/70)、10.9%(7/65)和7.4%(1/15),P=0.000;硬质支气管镜为2.0%(12/591)、纤维支气管镜为11.1%(12/108),P=0.000。结论:(1)气管异物影像检查以胸部X片、CT为主,检出阳性率较高。(2)气管支气管异物主要收治科室为耳鼻喉科,儿科、呼吸内科近年来收治病例数增加。气管异物取出方式逐渐由硬性支气管镜转向纤维支气管软镜。(3)随着诊治经验增加,病种平均住院日有缩短趋势。(4)并发症发生率或与不同科室及手术操作经验有关。

    Abstract:

    Objective The aim of this study was to present the characteristics of tracheobronchial foreign bodies (TFBs) in Guangxi, and to provide clinical experience and reference for its diagnosis and treatment in the general hospitals. Methods Medical records of 699 TFBs patients who were treated in otolaryngology head and neck surgery, pediatrics, respiratory medicine department and other departments in our hospital between January 2005 to December 2019 were evaluated retrospectively. Features of these TFBs were analyzed. Results A total of 699 cases were included in this study, including 549 cases (78.5%) in otolaryngology head and neck surgery department, 70 cases (10%) in pediatrics department, 65 cases (9.3%) in respiratory department and 15 cases (2.1%) in other departments. By 2019, the proportion of pediatric and respiratory cases increased to 56.10%, P=0.000. While the proportion of bronchofibroscope applications increased from 6.30% in 2012 to 61.00% in 2019. Cases were mostly examined by chest X-ray (253 cases,36.2%) and chest CT (404 cases, 57.8%). The detection rate of Chest X-ray and chest CT were 71.1% and 91.3% respectively (P=0.000). The average length of stays were 3.68 days,6.89 days and 11.00 days respectively in otolaryngology department, pediatrics department and in respiratory and other departments (P=0.000). The incidence of complications was 3.4% (24 / 699), including 2.0% (12 / 591) in the use of rigid bronchoscopy, and 11.1% (12 / 108) in fiber optic bronchoscopy (P= 0.000). Conclusion Both rigid bronchoscopy and fiber optic bronchoscopy can effectively remove the TFBs. Before removal of special and complex TFBs, multi-disciplinary team (MDT) consultation should be conducted to formulate a comprehensive treatment plan, to maximize the benefits of patients.

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  • 收稿日期:2021-09-03
  • 最后修改日期:2021-11-08
  • 录用日期:2021-11-17
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