Clinical Study Of Food-borne Tracheobronchial Foreign Body In Children

Objective To analyse the clinical characteristics of food-borne tracheobronchial foreign bodies in children,to evaluate the value of various clinical common indicators in the diagnosis and treatment of diseases,and explore the diagnosis and treatment of the disease,in order to reduce the misdiagnosis and missed diagnosis rate of food-borne foreign bodies,and avoid delays in treatment and reduce mortality as much as possible,at the same time,it guides the clinical mission work to prevent the occurrence of inhalation food-borne foreign bodies.Methods A retrospective analysis was performed to select 264 children with foodborne tracheobronchial foreign body who were hospitalized in the Department of Otorhinolaryngology and Respiratory Diseases of the Dalian Children's Hospital from January 2016 to February 2019.The following information was recorded for each patient: age,gender,history of foreign body inhalation,time of foreign body retention,type of foreign body and retention,clinical symptoms and signs,complications,auxiliary examination,etc.,the above clinical data were described and analyzed.Results 1.A total of 264 children with food-induced foreign bodies met the inclusion criteria.The age was 1-3 years old,accounting for 92.80%;the ratio of boys to girls was 1.72:1;the urban children and urban children accounted for 63.63% and 36.36% respectively;the largest number of peanuts,accounting for 54.92%;more than 50% of children in a day after inhaling foreign bodies;there was no significant difference in the incidence of foreign bodies on the left and right sides bronchus(P>0.05).There are 96.59% of those who have a history of inhalation of foreign bodies,of which 61.57% have incentives such as crying,falling,running,laughing.2.Among the 264 children with foreign body,the incidence of cough and wheezing was the highest,followed by fever,cyanosis,dyspnea,etc.;lung auscultation was weaker or wheezing accounted for more than 95%;lung emphysema was the most common complication,followed by pneumonia and atelectasis;there was no significant difference in the incidence of foreign body in the airway with emphysema or pneumonia(P>0.05).3.Among the 262 children with improved preoperative blood routine,the white blood cell count was 32.44% in the normal range and 45.04% in the mild range(located in 10-15*10^9/L);the differences in white blood cell counts in different foreign body retention time did not Statistical significance(P>0.05),but the difference of neutrophil percentage was statistically significant(P<0.05);the white blood cell count and neutrophil percentage in 3-7 days group were lower than ?1 day group(P< 0.05);of the 262 cases with improved lung CT+ airway three-dimensional reconstruction,79.01% directly showed the presence of foreign bodies;264 cases of foreign body children with intraoperative bronchoscopy showed purulent discharge accounted for 87.50%,mucosal congestion and swelling Accounted for 75.76%,granulation tissue proliferation accounted for 11.74%.As the foreign body stayed in the airway for different time,the difference of purulent secretion and granulation tissue was significant(P<0.05),and there was no significant difference in mucosal hyperemia and swelling(P>0.05).4.Among the 264 children with foreign bodies,152 patients were diagnosed within 24 hours and had a history of foreign body inhalation.150 of 152 patients completed preoperative blood routine,there was no significant difference in mean white blood cell count and mean neutrophil ratio between the nut group and the non-nut group(P>0.05).152 children underwent bronchoscopy with 120 cases of purulent discharge,107 cases of mucosal hyperemia and swelling,there were significant differences in purulent secretion and mucosal hyperemia between the nut group and the non-nut group(P<0.05).Conclusion 1.Children who inhaled food-borne tracheobronchial foreign body were mainly infants,more boys than girls,more children in urban areas than urban children,there was no significant difference in the incidence of bronchus on the left and right sides bronchus,cough is the most common clinical symptoms,emphysema for the most common preoperative complications;2.Peanuts,walnuts and other nuts are the most abundant,suggesting that parents and guardians should be given targeted health education,eating as much as possible after crushing the above foods,avoiding children's exposure to peanuts and other foods only,and minimizing the incidence of foreign body inhalation as much as possible.3.After inhaling food-induced foreign body,the CT+ airway three-dimensional reconstruction of the lungs of about 2/3 children can directly indicate foreign body shadow,this method has a high diagnosis rate of food-borne foreign bodies,and it is necessary to improve the examination of children with suspected food-borne foreign bodies.4.Inhalation of food-borne foreign bodies should be taken out as soon as possible to reduce the proliferation of local purulent secretions and granulation tissue,and reduce the damage of foreign bodies to the airway.