【摘要】 目的:分析经喉罩下支气管镜异物取出术的临床应用情况。方法:对2015年7月～2019年12月于福建省妇幼保健院就诊的226例气管支气管异物患儿的临床资料进行分析。所有患儿行喉罩下纤维支气管镜检查,明确有异物者行异物取出术,对术中、术后并发症的原因和处理方法进行总结。结果:1～3岁（64.60%）是儿童异物高发人群;男女比例约为2:1,异物以坚果类（83.18%）尤其花生为主;异物位置为支气管（87.17%）较多;咳嗽（93.81%）、气喘（59.73%）是其主要临床表现。本组患者中有39例（17.26%）患儿曾被误诊为支气管肺炎或其他呼吸系统疾病。224例患儿在经喉罩支气管镜异物取出术均1次成功,2例进行第2次手术后取出。并发症最常见为呼末CO₂增高及低氧血症,在操作过程中3例行心肺复苏术,术后应因喉水肿气管插管机械通气4例。结论:经喉罩支气管镜异物取出术为相对安全的手术方式,但应注意相关并发症并做好应急预案。更多还原

【Abstract】 Objective: To analyze the clinical application of bronchoscopic foreign body removal under laryngeal mask. Methods: The clinical data of 226 children with tracheobronchial foreign bodies treated in Fujian maternal and child health hospital from July 2015 to December 2019 were analyzed. All children underwent fiberoptic bronchoscopy under laryngeal mask, and those with foreign bodies were removed. The causes and treatment of intraoperative and postoperative complications were summarized. Results: 1～3 years old（64.60%） were the high incidence population of foreign bodies in children; The ratio of male to female was about 2:1, and the foreign bodies were mainly nuts（83.18%）, especially peanuts; There were more foreign bodies in the bronchus（87.17%）; Cough（93.81%） and asthma（59.73%） were the main clinical manifestations. In this group, 39 cases（17.26%） were misdiagnosed as bronchopneumonia or other respiratory diseases. 224 cases were successfully removed by laryngeal mask bronchoscope, and 2 cases were removed after the second operation. The most common complications were elevated CO₂ at the end of breath and hypoxemia. Cardiopulmonary resuscitation was performed in 3 cases, and endotracheal intubation and mechanical ventilation due to laryngeal edema in 4 cases. Conclusion: Laryngeal mask bronchoscopic foreign body removal is a relatively safe operation, but we should pay attention to the related complications and make an emergency plan.更多还原