文章摘要
陈进喜,高平明,林业辉,张洁妍,黄 殷,裴夫瑜.儿童气管支气管异物临床特征、延迟诊断因素及并发症高危因素分析[J].,2023,(11):2063-2067
儿童气管支气管异物临床特征、延迟诊断因素及并发症高危因素分析
Analysis of Clinical Features, Delayed Diagnosis Factors and Risk Factors of Complications of Tracheobronchial Foreign Body in Children
投稿时间:2023-01-12  修订日期:2023-01-31
DOI:10.13241/j.cnki.pmb.2023.11.012
中文关键词: 儿童气管支气管异物  临床特征  延迟诊断因素  并发症
英文关键词: Children tracheobronchial foreign body  Clinical features  Delayed diagnostic factors  Complication
基金项目:广东省医学科学技术研究基金项目(B2022233)
作者单位E-mail
陈进喜 南方医科大学第二临床医学院 广东 广州 510260南方医科大学附属佛山妇幼保健院儿科 广东 佛山 528000 fsfy259259@163.com 
高平明 南方医科大学第二临床医学院 广东 广州 510260南方医科大学附属佛山妇幼保健院儿科 广东 佛山 528000  
林业辉 南方医科大学附属佛山妇幼保健院儿科 广东 佛山 528000  
张洁妍 南方医科大学附属佛山妇幼保健院儿科 广东 佛山 528000  
黄 殷 南方医科大学附属佛山妇幼保健院儿科 广东 佛山 528000  
裴夫瑜 南方医科大学南方医院儿科 广东 广州 510515  
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中文摘要:
      摘要 目的:探讨儿童气管支气管异物临床特征、延迟诊断因素及并发症高危因素分析。方法:以我院2014年5月到2022年7月收治的167例疑似气管支气管异物患儿作为研究对象。167例患者中男性112例,女性55例,平均年龄(25.10±21.51)月。按照患儿支气管镜检查结果将患儿分为异物组(n=140)和非异物组(n=27)。按照患儿入院时气管支气管异物的确诊时间是否在24 h内将患儿分为延迟诊断组(n=100)和早期诊断组(n=40)。并依据气管支气管异物患儿是否发生并发症将所有患儿分为并发症组(n=122)和未发生并发症组(n=18)。采用x2检验和独立样本t检验进行亚组分析。采用logistics回归模型进行回归分析。结果:异物组和无异物组患儿性别、年龄、发病后就诊时间无显著差异(P>0.05);异物组和无异物组患儿的物滞留部位、CRP、PCT、首诊时影像学检查、患儿居住地、异物吸入史差异显著(P<0.05);以患儿是否发生延迟诊断作为因变量多因素logistics回归结果显示,年龄、首诊时影像学检查、患儿居住地、异物吸入史是独立危险因素(P<0.05);以患儿是否发生并发症作为因变量,多因素logistics回归结果显示,年龄、首诊时影像学检查、患儿居住地、是否延迟诊断及异物吸入史是独立危险因素(P<0.05)。结论:儿童气管支气管异物存在较明显的年龄特征,延迟诊断和并发症受年龄、异物吸入史和影像学检查等复杂因素影响。
英文摘要:
      ABSTRACT Objective: To explore the clinical characteristics, delayed diagnosis factors and complication risk factors of children with tracheobronchial foreign body. Methods: A total of 167 children with suspected tracheobronchial foreign bodies, admitted to our hospital from May 2014 to July 2022, were used as the study subjects. Among the 167 patients, 112 were male and 55 were female, with a mean age (25.10 ± 21.51) months. According to the results of bronchoscopy, the children were divided into foreign bodies (n=140) and non-foreign bodies (n=27). The child was divided into delayed diagnosis group (n=100) and early diagnosis group (n=40) according to whether the diagnosis time of the child was admitted within 24h. All children were divided into complications (n=122) and complications(n=18). Results: There were no significant differences between the foreign body group and the non-foreign body group in terms of gender, age, and time to see a doctor after onset(P>0.05). There were significant differences in the retention site, CRP, PCT, imaging at the first diagnosis, residence of the children and the history of foreign body inhalation(P>0.05). The multivariate logistics regression, with whether delayed diagnosis was the dependent variable, showed that age, imaging at first diagnosis, residence of the child, and history of foreign body inhalation were independent risk factors(P>0.05). The results of multifactorial logistic regression with the occurrence of complications as the dependent variable showed that age, imaging at the first visit, the child's place of residence, delayed diagnosis and history of foreign body aspiration were independent risk factors(P>0.05). Conclusion: Children with tracheobronchial foreign bodies have obvious age characteristics, delayed diagnosis and complications are affected by complex factors such as age, foreign body inhalation history and imaging examination.
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