背景:气管支气管异物(FB)抽吸(FBA)是一种威胁生命的紧急情况,主要在儿童和高龄时期观察到。早期诊断,可以使用支气管镜方法去除FB,而不会造成不可逆的损伤。
方法:这是一个单中心,回顾性观察性研究。通过支气管镜方法和/或放射学发现诊断为FBA的受试者,没有吸气FB的病史,并且被检测出具有超过30天的吸气FB的人被纳入研究。从医院信息数据库系统中调查了受试者的病历以及放射学和支气管镜检查结果。
结果:在255例FBA患者中,17.6%(N=45)诊断晚期。平均年龄为53岁;28%是女性,60%的受试者有吸烟史。FB在支气管系统中的估计停留时间为22.8个月。最常见的症状是咳嗽和呼吸急促。42%的抽吸FBs是有机材料。在6.7%的前胸片和65%的胸部计算机断层扫描(CT)扫描中可以观察到FB伪影。刚性支气管镜检查一直是首选的治疗性介入程序。还发现,伪影最常见于右支气管系统,最常见于右下叶,而85%的受试者形成肉芽组织。
结论:本研究的结果表明,受试者倾向于忘记FBA,导致潜在的呼吸系统症状,反复感染。在胸部CT上有支气管内肿块病变图像的情况下,临床医生应考虑FBA的可能性。有机和无机FB的延迟诊断可能会导致肉芽组织。
BACKGROUND: Tracheobronchial foreign body (FB) aspiration (FBA) is a life-threatening emergency mostly observed in childhood and advanced age. With early diagnosis, the FB can be removed using bronchoscopic methods without causing irreversible damage.
METHODS: This was a single-center, retrospective observational study. Subjects diagnosed with FBA via either bronchoscopic methods and/or radiological findings, having no medical history of aspirated FB, and who were detected to have aspirated FB for longer than 30 days were included in the study. Medical records and radiological and bronchoscopic findings of the subjects were investigated from the hospital information database system.
RESULTS: Of the 255 patients with FBA, 17.6% (N = 45) were diagnosed late. The mean age was 53 y; 28% were female, and 60% of the subjects had a history of ever smoking. The estimated residence time of the FB in the bronchial system was 22.8 months. The most common complaints were cough and shortness of breath. Forty-two percent of the aspirated FBs were organic material. FB artifact could be observed in 6.7% of posteroanterior chest radiographs and 65% of thorax computed tomography (CT) scans. Rigid bronchoscopy had been primarily preferred as therapeutic interventional procedure. It was also found that the artifact most frequently resided in the right bronchial system and was most commonly found in the right lower lobe, while granulation tissue was formed in 85% of the subjects.
CONCLUSIONS: The findings of the present study demonstrate that subjects tended to forget the FBA, leading to insidious respiratory system symptoms, with recurrent infections. In cases with an endobronchial mass lesion image on thorax CT, clinicians should consider the possibility of FBA. Delayed diagnosis of both organic and inorganic FB may cause granulation tissue.