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岭南现代临床外科 ›› 2019, Vol. 19 ›› Issue (05): 592-595.DOI: 10.3969/j.issn.1009-976X.2019.05.020

• 论著与临床研究 • 上一篇    下一篇

由嵌顿性声门异物演变为气管异物的抢救一例并文献复习

邹团明, 陈俊明, 虞幼军, 刘振*   

  1. 佛山市第一人民医院耳鼻喉科,广东佛山 528000
  • 通讯作者: 刘振

Foreign body inlaid in the glottis developed to tracheal foreign body: a case report and review of the literature

ZOU Tuanming, CHEN Junming, YU Youjun, LIU Zhen   

  1. Department of Otolaryngology, The First People′s Hospital of Foshan, Foshan 528000, China
  • Online:2019-10-20 Published:2019-10-20
  • Contact: LIU Zhen

摘要: 目的 探讨声门异物的临床表现、诊断及治疗方法。方法 结合文献复习,回顾性分析2018年6月12收治的一例由嵌顿性声门异物演变为气管异物患者资料。患者女,1岁3个月。因“误食鱼骨后咳嗽、拒食10天”入院。入院前予抗炎、雾化治疗未见好转,后经纤维喉镜检查提示声门异物。予全麻下行气管镜探查术,术中患者出现喉痉挛,血氧饱和度下降,行紧急气管插管后演变为气管异物,并再次在全麻下行气管镜探查取出术,手术过程顺利,取出异物。结果 术后第一天拔除气管插管,第13天患者无发热,无咳嗽咳痰,无声嘶气促,面色红润,听诊双肺呼吸音清,复查胸片提示肺炎基本痊愈及未见异物残留,予顺利出院。结论 喉异物、气管异物较常见,但由嵌顿性声门异物演变成气管异物罕见。有异物误吞史的患儿应考虑喉异物的可能,需完善相关检查及进一步明确诊断,并且选择适宜的麻醉方法及掌握手术技巧。

关键词: 嵌顿性, 气管异物, 抢救, 声门异物

Abstract: Objective To explore the clinical manifestations, diagnosis and treatment of the subglottic foreign body. Methods A case report and review of the literature. from a retrospective analysis of 12 June 2018, a case of the insinuated sound portal developed into a trachea foreign body. The patient, female, 1 year 3 months old, was admitted to the hospital for “10 days after eating fish bones.” Before the admission, the treatment of anti-inflammatory and atomizer was not effective, and the fiber laryngoscopy showed a foreign object. During general anesthesia downlink bronchoscope surgical exploration, laryngospasm and oxygen desaturation occurred, emergency tracheal intubation and evolution of trachea was applied with the bronchoscope under general anesthesia. The foreign body was removed successfully. Results The procedure went well the first postoperative day and 13 days after tracheal intubation. The patient had no fever, cough and expectoration, without shortness of breath or rosy. The lung auscultation breath sounds was clear. Review of X-ray suggests basic healing and no foreign body residual or pneumonia. She discharged from hospital. Conclusion Laryngeal foreign body and tracheal foreign body are common, but it is rare to develop into the endotracheal foreign body. A history of foreign body ingestion of children should be considered the possibility of laryngeal eyewinker and needs relevant examination and further diagnosis. Suitable operation and anesthesia method should be chosen.

Key words: tracheal foreign body, the subglottic foreign body, nested, rescue

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