目的:气管支气管异物抽吸术是儿科常见的急症,也是儿童意外死亡的主要原因。即使进行身体检查,诊断有时仍然很困难。病史,和基本的X光片.这种挑战需要在全身麻醉下进行内窥镜检查,不管严重并发症的可能性。诸如呼气胸部X射线之类的策略减少不必要的内窥镜检查的益处仍然不确定。我们评估了呼气胸部X射线在检测气道异物方面的有效性,以潜在地减少对内窥镜的需要。
方法:我们对疑似异物吸入的儿童进行了X线和内窥镜检查。
结果:共有70名儿童被纳入研究。在这些中,19例(27.1%)标准胸部X线片显示病理结果。然而,当增加呼气胸部X光片时,病理X线检查增加至37例(52.9%)。在在场的36具异物中,只有2个没有被检测到。此外,3次胸部X光显示病理结果,而内窥镜检查显示正常。因此,整体灵敏度,特异性,正预测值,阴性预测值为94.4%,91.1%,91.9%,分别为93.9%。
结论:呼气胸片的显着敏感性可以消除不必要的内窥镜检查,但应仅限于无法使用MDCT的中心。只有在听诊期间观察到持续的临床症状时,才应考虑内窥镜检查的性能。
OBJECTIVE: Tracheobronchial foreign body aspiration is a common pediatric emergency and a leading cause of accidental deaths in children. The diagnosis remains sometimes difficult even with physical examination, medical history, and basic X-rays. This challenge necessitates the performance of endoscopy under general anesthesia, regardless of the potential for serious complications. The benefit of strategies like expiratory chest X-rays to reduce unnecessary endoscopies remains uncertain. We evaluated the effectiveness of expiratory chest X-rays in detecting airway foreign bodies to potentially reduce the need for endoscopies.
METHODS: We retrospectively studied children with suspected foreign body aspiration who had X-ray and endoscopy.
RESULTS: A total of 70 children were included in the study. Out of these, 19 cases (27.1 %) showed pathological findings on standard chest X-rays. However, when expiratory chest X-rays were added, the number of pathological radiographies increased to 37 cases (52.9 %). Out of the 36 foreign bodies that were present, only 2 were not detected. Furthermore, 3 chest X-rays displayed pathological results, while the endoscopies indicated normal findings. Consequently, the overall sensitivity, specificity, positive predictive value, and negative predictive value stood at 94.4 %, 91.1 %, 91.9 %, and 93.9 % respectively.
CONCLUSIONS: The remarkable sensitivity of expiratory chest radiography can eliminate the need for unnecessary endoscopy, but it should be limited to centers lacking access to MDCT. The performance of endoscopy should only be considered when persistent clinical symptoms are observed during auscultation.