儿童支气管异物32例误诊分析

支气管异物系儿科常见病，误诊原因很多，如病史陈述不详细、辅助检查的干扰等，更重要的一个原因就是异物的不典型位置。传统观念中，右下肺异物高发，实际上，受气流及异物体积的影响，轻而小的塑料可被回吸进入左上肺，而较大的异物受自身重力影响多进入右下肺。异物进入体内，引起的·临床表现多种多样，咳嗽、咯血、喘息甚至呼吸困难等，诸类症状在呼吸系统疾病中较为常见，因此这些症状的鉴别就显得尤为重要。在治疗方面，突破传统的支气管镜技术，提倡可以首先采取保守治疗，给予拍背、体位引流等手段，部分患儿可自行咳出异物，这样就避免了手术的风险，在保守治疗无效的情况下可转入外科通过纤维支气管镜取出。

Thirty-two Cases of Children Bronchial Foreign Body Misdiagnosis Analysis

Bronchial foreign body is a kind of common disease in pediatrics. It has many reasons for the misdiagnosis, such as lack of detail history statements, the interference of auxiliary examination, etc. An important reason is that nontypical location of foreign bodies. In the traditional concept, right lung is the high incident location of foreign bodies. In fact, under the influence of air flow and foreign body volume, light and small plastic can be sucked into the upper left lung back while larger foreign body is influenced by its own gravity into the right lower lung. After the foreign body gets into the body, it will cause a variety of clinical manifestations. Cough, hemoptysis, wheezing or breathing difficulties, etc, are common symptoms in the respiratory system disease, so it is particularly important to identify these symptoms. In the aspect of treatment, break through the traditional bronchoscope technology, conservative treatment can be promoted to take first, for example, to give back, postural drainage measures. Some children can cough up foreign body, thus avoiding surgery. In the case that conservative treatment is invalid line, it can be transferred to surgical hronchoscopy mirror.