| Objective: To explore the clinical characteristics of tracheobronchial foreign body,,the influence factors of preoperative pulmonary complications, diagnosis and treatment.and to improve the level of diagnosis andtreatment. Methods:Collect the clinical data of the 310 cases of suspected patients with tracheobronchial foreign body which were diagnosised and treated in the otolaryngology and pneumology department of the second affiliated hospital of fujian medical university from January 2006 to December 2014. And retrospectively analyzed the clinical manifestations and diagnosis and treatment process.of the 289 patients who was treated with bronchoscopy were retrospectively analyzed. Results: In the 289 cases of patients, there were 273 cases confirmed the disease and 16 cases were not the disease, there were included 240 cases of children and 33 cases of adult of the confirmed patients.the children group were in the majority with l ~ 3 years old, which was accounted for 64.15%, The proportion of boys and girls was about 1.82:1.Plant foreign body is the most common type. accounting for 84.58% in the children group, peanut is the most common type of plant foreign body, which is accounted for 73.9% of them.Bronchial foreign body on the right side is more than that on the left side, the left side account for 30.77%, the right side account for 39.19%. There are 191 patients with preoperative pulmonary complications of the 273 confirmed cases,the complication rate is closely related to the age of onset, sex, the nature, the retention time and the retention area of foreign body, That can provide clear history account for 76.92% in the 273 confirmed patients, its diagnosis coincidence rate is high. In the 289 cases of patients, The diagnosis of chest X-ray radiography were as fellows: sensitivity 61.9%, specificity 30.8% and accuracy 59.5%; The diagnosis of chest X-ray perspective were as fellows: sensitivity 80.2%, specificity 28.6% and accuracy 76.3%; The diagnosis of Chest computed tomography(CT) were as fellows:sensitivity 97.1%, specificity 50% and accuracy 94.1%, so the method of the highest rate of diagnos is CT among imaging examination,perspective is the second and radiography is the lowest.Children group of 240 cases, There are 236 cases were operated by rigid bronchoscopy in general anesthesia; among them,4 cases who were not removed foreign body did not want to operate again or required to other hospital therapy; 1 case was removed foreign body by openning thoracic surgery which was unsuccessly operated by rigid bronchoscopy, 3 cases of death, the death rate is 1.25%; The remaining 228 cases were successly removed the foreign body by rigid bronchoscopy,the surgical success rate is 96.61%; Adult group of 33 cases, There are 26 cases were successly removed the foreign body by Fiberoptic bronchoscopy in local anesthesia.no death case. Conclusion: 1. The incidence of children’s tracheobronchial foreign bodies is high,especially among l ~ 3 years old, and boys is higher than girls; adult’s tracheobronchial foreign bodies is less than children; Plant foreign body is the most common type;the retention area of foreign body are closely related with its nature,size, shape, weight, patients’ position when foreign body was aspirated, the anatomical factors and so on. 2. The incidence of preoperative pulmonary complications of tracheobronchial foreign body is closely related to patient’s age, sex, the kind of naturre, the retention time and retention area of foreign body, but that has nothing to do with the sex of the patients. 3. The aspirate history of foreign body is very important for the diagnosis of tracheobronchial foreign body; imaging examination is the most important method of diagnosis of this disease, Compare CT. X-ray perspective and radiography respectively, the method of the highest rate of diagnos is CT, perspective is the second and radiography is the lowest; The reason of misdiagnosis of this dease mainly include the unknown history of foreign body, atypical clinical manifestations, negative of imaging examination and poor understanding. 4. Rigid bronchoscopey and with video of tracheal endoscopy in extraction of foreign body is the main method for the treatment of tracheobronchial foreign body; Bronchoscopy surgical skills play an important role on improving surgical success rate of TFB; Fiberoptic bronchoscopy has its unique effect and advantages in the treatment of this disease and it can consider the most important method of removing foreign bodies from the airways of adults; Early found and treatment is the key to prevent postoperative complications. |
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