頁籤選單縮合
題名 | Tracheobronchial Foreign Body Aspiration in childhood=兒童氣管支氣管內異物吸入症 |
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作者 | 陳厚全; |
期刊 | 中華民國外科醫學會雜誌 |
出版日期 | 19910100、19910200 |
卷期 | 24:1 民80.01-02 |
頁次 | 頁531-537 |
分類號 | 417.6891 |
語文 | eng |
關鍵詞 | 兒童氣管支氣管; 異物吸入症; |
中文摘要 | 台中及台北榮民總醫院自1981年元月至1990年4月共有100位兒童發現有氣管或支氣管內異物吸入,年齡最小的為7個月,最大的為14歲,小於3歲的共佔79%。最常見的臨床症狀為咳嗽(76%),喘嗚(64%)及呼吸音減少(67%)。有84位病人於病史上可以追知有過硬噎的情形。最常見的胸部X光發現為阻塞性肺氣腫,但是有24%的病人胸部X光檢查為正常。單側支氣管異物佔83%,氣管內異物佔13%,兩側支氣管內都有異物者為4%,於單側支氣管異物吸入者右側佔55%,左側佔45%。而所吸人的異物以花生(54%)及水果的種子(26%)最為常見。所有的異物都以硬式小兒氣管鏡順利摘除。除了一個死亡的病例外,沒有其它嚴重的合併症。 雖然有78%的病人於發生異物吸入後一週內就醫診斷,但只有31%的病人是在24小時內早期就醫治療。我們認為治療的延誤一方面是因為家長的忽略,另一方面是臨床醫師之警覺性不夠。 如果病人曾有硬噎的情形加上有咳嗽、喘嗚、呼吸音減少以及胸部X光的發現則要高度懷疑有氣管支氣管異物吸入的可能性。如果能夠避免讓兒童於進食時嬉戲或避免讓幼兒吃花生,瓜子等食物,相信可以大為減少此種意外的發生。 |
英文摘要 | One hundred children were treated for tracheobronchial foreign body aspiration from January, 1981 to April, 1990. The youngest patient was 7-month-old and 79% of the patients were under 3 years of age. The commonest presenting symptoms and signs were cough (76%), wheezing (64%) and decreased breathing sounds (67%). Eighty-four patients had a history of witnessed chocking. Obstructive emphysema was the most common radiological finding. However, in 24% of all patients the radiological findings were normal. The foreign bodies were found to be unilateral bronchial in 83%, tracheal in 13% and bilateral bronchial in 4% of the patients. In patients with unilateral aspiration 55% were on the right side and 45% on the left. Peanuts (54%) and other fruit seeds (26%) were the most common foreign bodies encountered. All the foreign bodies were removed successfully by using a rigid pediatric bronchoscope. Except one mortality there was no other complications. Although 78% of our patients were diagnosed within one week after aspiration, only 31% of all patients were treated early (during the first 24 hrs after aspiration). Delay in diagnosis appears to result from either failure by parents to seek early medical attention or failure by physician to give serious consideration to the diagnosis. The possibility of tracheo-bronchial foreign body aspiration is highly suspected when a patient presents an obvious history of chocking followed by the clinical triad of cough, wheezing and decreased breath sound as well as a positive chest X-ray finding. The incidence of tracheobronchial foreign body aspiration may be decreased with advice for the public and parents against giving peanuts or sunflower seeds to small children, especially when they are playing or crying. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。