Analysis Of Clinical Characteristics Of Tracheobronchial Foreign Bodies In Children

Objective:To find the epidemiological characteristics of tracheobronchial foreign bodies(TFB)of children,and to optimize the educational methods of children’s TFB injury by analyzing the clinical comprehensive characteristics of children’s TFB.To explore the related factors and prognosis of TFB with granulation formation,so as to provide the valuable experience of the diagnosis and treatment for TFB with granulation in children.Methods:Sixty-nine children with TFB diagnosed by otorhinolaryngology,pediatrics and emergency department from August 2014 to April 2019 were retrospectively collected in our hospital.All children underwent the bronchoscopy and Chest CT examination,both of which were confirmed the TFB.The SPSS 22.0 software was used for statistical analysis of clinical data.The Chi-square test was performed for categorical variables.The independent sample T test or the univariate analysis of variance was applied for the continuous variables with normal distribution.And the Mann-Whitney U test or the nonparametric Kruskal-Wallis H test was used for the continuous variables with non-normal distribution.In the meanwhile,the Spearman correlation analysis was carried out among the variables with statistical significance.And the independent risk factors of granulation formation of foreign body in respiratory tract were investigated by binomial logistic regression analysis.The receiver operating characteristic curve(ROC)was applied for the predictive performance of granulation formation.Results:Among the 69 children with TFB,there were 46 males(66.7%)and 23 females(33.3%).The average age was 19.5 months and the number of children aged from one to three accounted for 84.1%totally.The children with TFB lived in rural areas more than in cities.The duration of disease mainly concentrated in 7 days and after,accounting for43.5%.The main clinical symptoms and signs were cough(98.55%),unilateral dyspnea(71.01%),gasp(60.87%)and wheezes(47.83%).The types of TFB were associated statistically with the unilateral dyspnea,respiratory failure and admission to intensive care unit(ICU)(P=0.002～0.043).Moreover,there was a weak negative correlation between the types of TFB and unilateral dyspnea(r=-0.321,P=0.007),and were weakly and positively correlated with respiratory failure and ICU admission(r=0.348,0.371,P=0.003,0.002).There were significant differences between the granulation formation of TFB and fever,unilateral dyspnea and bronchial stenosis,respectively(x~2=4.186～6.640,P=0.010～0.041),and showed a weak to moderate positive correlation(r=0.246～0.310,P=0.009～0.041).However,the granulation formation of TFB was not associated with the complications of pneumonia,atelectasis,emphysema,mediastinal deviation,bronchial occlusion,bronchiectasis and respiratory failure,respectively(P>0.05).After adjusting the duration of disease in the logistic regression model,the risk of granulation formation of airway foreign body with unilateral dyspnea was higher than that of patients without unilateral dyspnea(OR=5.72,95%CI:1.45-22.52).The ROC curve analysis showed that the area under the curves(AUCs)predicted for granulation formation by the unilateral dyspnea,the duration of the disease and the logistic model were 0.612,0.741,0.765,respectively.Conclusion:The TFB are common in children under 3 years old.The clinical symptoms and signs of TFB are mainly cough,unilateral dyspnea,gasp and wheezes.The unilateral dyspnea and the duration of disease are the independent risk factors of granulation formation of airway foreign body.The risk of granulation formation with unilateral dyspnea was higher than that of patients without unilateral dyspnea.