Abstract：【Objective】To investigate the clinical characteristics of tracheobronchial foreign bodies in children for their diagnostic value in sensitivity and specificity.【Methods】From September 2012 to September 2016, a total of 152 pediatric patients with suspected tracheobronchial foreign bodies were included in this study. The history of foreign body aspiration, clinical manifestation, chest X-ray examination and CT scanningwere analyzed.【Results】Tracheobronchial foreign body diagnosis was confirmed by bronchoscopy. Judged by this standard, patients with positive foreign body aspiration history,inspiratory dyspnea, diminished breath sounds on one side of the chest or asymmetric breath sounds onboth sides of the chest, X-ray and CT scan findings in the chest had a higher rate of foreign bodies present; the difference was statistically significant (P<0.05). However, differences in rates of irritating cough, fever, and lung rale were not statistically significant (P>0.05) . History of foreign body aspiration, inspiratory dyspnea, diminished breath sounds on one side of the chest or asymmetric breath sounds on two sides of the chest, chest X-ray findings, and CT scan showed a high sensitivity and positive predictive value that coincided with tracheobronchial foreign body diagnosis, but the specificity was not high. Foreign body aspiration history and chest CT scan had a high consistency with rigid bronchoscopy.【Conclusion】Inspiratory dyspnea, diminished breath sounds on one side or asymmetric breath sounds on two sides of the chest, and chest X-ray findings have some reference value for tracheobronchial foreign body diagnosis. The history of foreign body aspiration and chest CT scan can provide higher diagnostic value with more accuracy.
杨枝芳,朱胜华. 儿童气管、支气管异物各临床特征的诊断价值研究[J]. 医学临床研究, 2017, 34(6): 1105-1108.
YANG Zhi-fang, ZHU Sheng-hua. Analysis of Sensitivity and Specificity of Clinical Features of Tracheobronchial Foreign Body Diagnosis in Children. JOURNAL OF CLINICAL RESEARCH, 2017, 34(6): 1105-1108.
[1] Gang W, Zhengxia P, Hongbo L,et al.Diagnosis and treatment of tracheobronchial foreign bodies in 1024 children [J]. J Pediatr Surg,2012,47(11):2004-2010. [2] Singh A, Ghosh D, Samuel C, et al. Pediatric foreign body aspiration: how much does our community know [J]. Indian Assoc Pediatr Surg,2010,15 (4) :129-132. [3] Cutrone C, Pedruzzi B, Tava G,et al.The complimentary role of diagnostic and therapeutic endoscopy in foreign body aspiration in children [J]. Int J Pediatr Otorhinolaryngol,2011,75(12):1481-1485. [4] Zhijun C, Fugao Z, Niankai Z,et al.Therapeutic experience from 1428 patients with pediatric tracheobronchial foreign body [J]. J Pediatr Surg,2008,43(4):718-721. [5] 王崇稳,代燕增.呼吸气像胸片与MSCT检查在小儿支气管异物中的诊断价值[J].世界最新医学信息文摘,2014,14(7):180-181. [6] Fidkowski CW, Zheng H, Firth PG. The anesthetic considerations of tracheobronchial foreign bodies in children: a literature review of 12,979 cases [J]. Anesth Analg,2010,111(4):1016-1025. [7] Ciftci AO,Bingol-Kologlu M,Senocak ME, et al. Bronchoscopy for Evaluation of Foreign Body Aspiration in Children [J]. J Pediatr Surg,2003,38(8):1170-1176. [8] 刘冰,张杰,刘世琳,等.小儿气管支气管异物诊断指标的量化评分及其对治疗的意义[J].中国耳鼻咽喉头颈外科杂志,2009,16(5):277-279. [9] 段效军,陈艳萍,仇君.儿童气管支气管异物的临床特征分析[J].中国当代儿科杂志,2014,16(4):410-413. [10] Hitter A, Hullo E, Durand C,et al. Diagnostic value of various investigations in children with suspected foreign body aspiration Review [J]. Eur Ann Otorhinolaryngol Head Neck Dis,2011,128(5):248-252. [11] Foltran F, Ballali S, Passali FM, et al. Foreign bodies in the airways: a meta-analysis of published papers [J]. Int J Pediatr Otorhinolaryngol,2012,76(1):12-19. [12] Brown JC, Chapman T, Klein EJ, et al. The Utility of Adding Expiratory or Decubitus Chest Radiographs to the Radiographic Evaluation of Suspected Pediatric Airway Foreign Bodies [J].Ann Emerg Med,2013,61(1):19-26. [13] 吴显阳,赵珑.多层螺旋CT和同层动态CT电影扫描对小儿气管异物的诊断价值[J].中国医学影像技术,2010,26(1):86-88. [14] Cavel O, Bergeron M, Garel L, et al. Questioning the legitimacy of rigid bronchoscopy as a tool for establishing the diagnosis of a bronchial foreign body [J]. Int J Pediatr Otorhinolaryngol,2012,76(2): 194-201. [15] Saki N, Nikakhlagh S, Rahim F, et al. Foreign body aspirations in infancy: a 20-year experience [J]. Int J Med Sci,2009,6(6):322-328. (本文编辑:师晓阳) [收稿日期] 2016-12-05
2017, Vol. 34 
