The Epidemiological Features And Early Diagnostic Of Foreign Body Aspiration In Children Of Hunan Province From 2011 To 2015

Objective:In order to explore the epidemiological characteristics of foreign bodies aspiration in Hunan province to provide effective basis for reducing the occurrence, and analysis the value of early diagnosis to provide the precious clinical experience, we study 2846 surgery cases of foreign bodies aspiration in children. Subjects and Methods:A total of 2864 surgery cases from Hunan Province who was diagnosed with children foreign bodies aspiration was selected in our study. Retrospective investigation and analysis the epidemiological characteristics of 50 cases of nasal foreign body, 23 cases of pharyngeal foreign body, 39 cases of laryngeal foreign body, 477 cases of foreign body in trachea, 2257 cases of bronchial foreign body. Based on the study of Institute of Child Health in Turkey, 2773 cases of foreign body in laryngeal, trachea and bronchial were grouped as Early diagnosis group(less than 24 hours) and Late diagnosis group(more than 24 hours). Results:1.Epidemiologic features of foreign bodies aspiration in children: The morbidity of foreign bodies aspiration in children consistently grew from the year 2011 to 2015 in Hunan province. And the morbidity was higher in male and rural population. The morbidity of male female ratio and urban rural ratio was 1.89:1 and 1:2.31 respectively in our study. Moreover, it occurred more frequently in winter(31.38%), and more distributed in the north and west of Hunan province relatively. In addition, foreign bodies aspiration likely attacked children under 3 years old(87.28%).2.The characteristics of foreign bodies: 90.85% of the foreign bodies which lead to airway obstruction in children was plant. In our study, peanut caused 1249 cases(48.45% in planting) of patient with foreign bodies aspiration, sunflower seeds caused 745 cases(28.9% in planting). The most common foreign bodies in the trachea or bronchus was also plant, there are 431 cases in trachea(90.36%) and 2111 cases in bronchus(93.53%). And 19 cases of plant(48.72%) and 16 cases of animal foreign bodies in larynx(41.03%). The most common foreign bodies in pharyngeal was animal bone chip and fishbone(47.83%). However, 20 cases nasal foreign body(40%) was more likely to be metal objects, such as the 16 cases of button battery.3.The early diagnosis of foreign bodies aspiration in children: Unfortunately, only 539 cases(18.94%) attacked by foreign bodies aspiration were treated within 24 hours. In our study, 72.90% of children’s respiratory tract foreign bodies inducing factors is crying while feeding, the nasal foreign body was caused by unexpected stuff. Improper swallowing was the most important cause of foreign body in pharynx. The most common symptoms of foreign bodies aspiration in children included: cough(96.77%), anhelation(91.43%), laryngeal stridor(91.36%). The most common sign included: pulmonary rale(93.11%), unilateral decreased respiration(80.99%), mediastinal swing(18.31%).4. The result of foreign bodies aspiration in children: Among all the cases, 2 cases(0.07%) occurred edema of the larynx, 2 cases(0.07%) occurred pneumonedema, 4 cases(0.14%) occurred aerothorax and 3(0.11%) cases occurred aerodermectasia after the operation,. Moreover, 17(0.60%)case of foreign bodies aspiration were transferred to ICU for further treatment, 4 cases(0.14%) needed re-operation and 1 case(0.04%) died.5. Statistical characteristics of foreign bodies aspiration in children:The difference of the hospitalization time in different sex of children, sex in urban and rural children all had no statistical difference(P﹥0.05). However, the duration of disease, types of foreign bodies between urban and rural children, the position and types of foreign bodies all had statistical difference with the duration of disease(P<0.05). Moreover, the positon and types of foreign bodies had statistical difference between Early diagnosis group and Late diagnosis group(P<0.05). In addition, the difference of fever, three depressions sign, unilateral decreased respiration, pneumonia and pneumonectasis were significant between Early diagnosis group and Late diagnosis group(P<0.05). Conclusion:1. Foreign bodies aspiration was more likely to attack children under 3 years old. And the morbidity was higher in rural population, males than females. It occurred more frequently in winter, Plants is the most common type of children’s airway foreign bodies in children. The types of foreign body was more widely in rural areas.2.To get early diagnosis and effective treatment, the clinical doctors should be more vigilant about the possibility of foreign bodies aspiration in children.