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Title: [Analysis of the diagnosis and treatment of 10 cases of complex respiratory foreign bodies in children].
Author: Yan Y, Bi J, Liu J, Tao X, Fu Y.
Journal: Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi; 2024 Feb; 38(2):155-159. PubMed ID: 38297871.
Abstract:
Objective:To explore the diagnosis and treatment experience of complex respiratory foreign bodies in children. Methods:The clinical data of 1 243 cases of respiratory foreign bodies in children were retrospectively analyzed, among which 10 cases（0.8%） were complicated respiratory foreign bodies. Results:Among the 10 cases of complex respiratory foreign bodies, 2 cases were removed by open thoracotomy, 1 case was removed by tracheotomy, 1 case was removed by lobectomy, 1 case was removed by fiberoptic bronchoscopy because of difficult airway caused by the accompanying congenital pulmonary artery sling, and the pulmonary artery sling correction was synchronized with the fiberoptic bronchoscopic removal, 3 cases were removed by fiberoptic bronchoscopic holmium laser and/or freezing method to make the foreign body deformed and fragmented and then taken out by the sound gate, and 2 cases were removed because of the In 3 cases, the foreign bodies were deformed and fragmented by fiberoptic bronchoscopy, and in 2 cases, the foreign bodies were removed through the vocal folds because of their special characteristics. Two cases were intubated and sent to ICU after surgery because of obvious vocal edema and difficulty in deoxygenation, two cases were transferred to ICU after cardiac or thoracic surgery, and the rest of them returned to ordinary wards after surgery, and all 10 cases recovered well after surgery. Conclusion:Respiratory foreign body combined with airway stenosis, when the foreign body type, shape, embedded location of special foreign body, foreign body is too large, need to rationally choose the method of foreign body removal. If necessary, a combination of methods can be used to ensure that the airway obstruction is quickly relieved with the best program. 目的：探讨儿童复杂呼吸道异物的诊治经验。 方法：回顾性分析1 243例儿童呼吸道异物的临床资料，其中10例（0.8%）复杂呼吸道异物。 结果：10例复杂呼吸道异物患儿中，2例通过开胸手术取出；1例气管切开取出；1例予以肺叶切除取出；1例因伴有先天性肺动脉吊带导致困难气道，予纤维支气管镜下取出后同步进行肺动脉吊带矫治术；3例通过纤维支气管镜下钬激光和（或）冷冻方法使异物变形、碎裂后通过声门取出；2例因异物特殊，硬支气管镜联合纤维支气管镜下取出。术后2例患儿因声门水肿明显，脱氧困难予插管送至ICU，2例因心脏或胸外科手术后，转至ICU病房，其余均在术后回普通病房。术后患儿均恢复良好。 结论：呼吸道异物合并气道狭窄，异物种类、形状、嵌顿位置特殊，异物过大时，需合理选择异物取出的方法，必要时可采取多种方法联合使用，确保以最佳方案快速解除呼吸道梗阻。.

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