13例医源性气管支气管异物的临床分析

Clinical analysis of 13 patients with iatrogenic tracheobronchial foreign body

摘要:

目的 探讨医源性气管异物的临床特点、治疗方法及预防措施。方法 回顾性分析13例医源性气管异物患者的临床资料，13例异物中来源于患者自身组织7例，外来异物6例。异物位于主气管5例，左侧支气管3例，右侧支气管4例，位置不详1例。无明显临床症状者8例，单纯呛咳2例，呛咳伴喘鸣音、呼吸困难3例。采用硬质支气管镜取出异物5例，纤维支气管镜5例，其他方式3例。结果 13例患者均顺利取出异物，除拔牙造成气管异物的患者术后出现气胸转胸外科进一步治疗外，其他患者未出现明显并发症。结论 医源性气管异物发生原因多样，临床表现缺乏特异性，在临床工作中应注重预防，治疗上应根据其不同的临床特点选择相应的方式取出异物。

关键词:气管异物;支气管异物;医源性;临床资料

Abstract:

Objective To investigate the clinical characteristics, treatment and precautionary measures for iatrogenic tracheal foreign body. Methods Clinical data of 13 patients with iatrogenic tracheal foreign body were analyzed retrospectively. The source of foreign body was autologous in 7 cases and alien in 6. The foreign bodies were located in the main trachea in 5 cases, left bronchus in 3, right bronchus in 4 and unknown location in one, respectively. Of them, 8 cases had no obvious clinical symptoms, 2 had simple choking cough and 3 had choking with wheezing and dyspnea. The foreign body was removed by rigid bronchoscope in 5 cases, by fiber bronchoscope in another 5 and by other methods in 3. Results Removal of foreign body was successfully performed in all the 13 cases. Pneumothorax developed after removal of the tracheal foreign body caused by tooth extraction and required further thoracic surgery treatment in one patient, and there were no obvious complications in other patients. Conclusions The causes of iatrogenic tracheobronchial foreign body were various and the clinical manifestations were lack of specificity. The focus must be on prevention in clinical practice, and an appropriate method should be selected for removal of foreign body according to the different clinical characteristics.

Key words:Tracheal foreign body;Broncheal foreign body;Iatrogenic;Clinical data