Clinical characteristics of tracheobronchial foreign body in children:A report of 228 cases / 中国实用儿科杂志

ABSTRACT

OBJECTIVE: To explore the clinical characteristics,diagnosis and treatment of tracheobronchial foreign body in children and analyze the risk factors for granuloma formation. METHODS: A retrospective analysis of 228 children diagnosed withtracheobronchial foreignbody was carried out,who were treated between January 2011 and December 2017,and the binary Logistic regression on risk factors of secondary airway intimal granulation after tracheobronchial foreign body was done.RESULTS: The high incidence age of tracheobronchial foreign body in children was 1～3 years old(76.3%),and the ratio of male to female was 2.3∶1. The plant foreign bodies were the main proportion(82.9%),and the foreign bodies in left lung(52.6%)was slightly higher than in the right lung(39.5%). Endotracheal granulation(74.4%),pneumonia(76.3%)and emphysema(51.3%)were the most common complications of tracheobronchial foreign body. The type and the remaining time of foreign body were the independent risk factor for the formation of endotracheal granulation(P<0.01). The longer the disease duration,the greater the risk of granulation formation(P<0.01). The ROC curve showed that the remaining time of foreign bodies could be used as a reliable indicator of endotracheal granulation,critical values of the independent correlation factor was the course of disease more than 7.5 d. All the foreign bodies in 228 cases(100%)were successfully removed by fiberoptic bronchoscopy under local anesthesia,226 cases of 1-time take-out(success rate 99.1%),and no obvious complications occurred during and after surgery. CONCLUSION: Children aged from 1 to 3 years old are the high incidence of respiratory foreign body,and plants are more common. Plant foreign body residue is prone to endotracheal granulation,and the longer thecourse,the higher risk the granulation. Avoiding feeding infants nuts,early identification and correct diagnosis,and choosing the suitable operation method is the key to preventing and treating foreign body inhalation.