机构:[1]Capital Med Univ, Beijing Childrens Hosp, Dept Otolaryngol Head & Neck Surg, 56 Nanlishi Rd, Beijing 100045, Peoples R China;临床科室耳鼻咽喉头颈外科首都医科大学附属北京儿童医院[2]Capital Med Univ, Beijing Pediat Res Inst, Beijing Key Lab Pediat Dis Otolaryngol Head & Nec, Beijing 100020, Peoples R China
Background: Pneumomediastinum (PM) secondary to foreign body aspiration (FBA) is rare in children. Although it is mainly benign, some cases may be fatal. Due to the rare nature of this clinical entity, proper assessment and management have been poorly studied so far. Here, we characterized the presentation and management of this clinical entity and provided an evaluation system for the management. Methods: We retrospectively reviewed children with PM secondary to FBA, who were treated in Beijing Children's Hospital from January 2010 to December 2015. All patients were stratified according to the degree of dyspnea on admission, and interventions were given accordingly. Bronchoscopic removals of airway foreign bodies (FBs) were performed on all patients. For patients in acute respiratory distress, emergent air evacuation and/or resuscitations were performed first. Admission data, interventions, and clinical outcomes were recorded. Results: A total of 39 patients were included in this study. The clinical severity was divided into three grades (Grades I, II, and III) according to the degree of dyspnea. Thirty-one patients were in Grade I dyspnea, and they simply underwent bronchoscopic FBs removals. PM resolved spontaneously and all patients recovered uneventfully. Six patients were in Grade II dyspnea, and emergent drainage preceded rigid bronchoscopy. They all recovered uneventfully under close observation. Two exhausted patients were in Grade III dyspnea. They died from large PM and bilateral pneumothorax, respectively, despite of aggressive interventions in our hospital. Conclusions: PM secondary to FBA could be life-threatening in some patients. The degree of dyspnea should be evaluated immediately, and patients in different dyspnea should be treated accordingly. For patients in Grade I dyspnea, simple bronchoscopic FBs removals could promise a good outcome. For patients in Grade II dyspnea, emergent air evacuation and/or resuscitation should precede a bronchoscopy before the children become exhausted.
基金:
Beijing Municipal Administration of Hospital Clinical Medicine Development of Special Funding Support [ZYLX201508]; Grading System of Foreign Body Aspiration in Children [Z131100006813028]; Beijing Municipal Science and Technology Project [D131100005313014]
第一作者机构:[1]Capital Med Univ, Beijing Childrens Hosp, Dept Otolaryngol Head & Neck Surg, 56 Nanlishi Rd, Beijing 100045, Peoples R China;
通讯作者:
通讯机构:[1]Capital Med Univ, Beijing Childrens Hosp, Dept Otolaryngol Head & Neck Surg, 56 Nanlishi Rd, Beijing 100045, Peoples R China;[2]Capital Med Univ, Beijing Pediat Res Inst, Beijing Key Lab Pediat Dis Otolaryngol Head & Nec, Beijing 100020, Peoples R China
推荐引用方式(GB/T 7714):
Yang Xiao-Jian,Zhang Jie,Chu Ping,et al.Pneumomediastinum Secondary to Foreign Body Aspiration: Clinical Features and Treatment Explorement in 39 Pediatric Patients[J].CHINESE MEDICAL JOURNAL.2016,129(22):2691-2696.doi:10.4103/0366-6999.193450.
APA:
Yang, Xiao-Jian,Zhang, Jie,Chu, Ping,Guo, Yong-Li,Tai, Jun...&Ni, Xin.(2016).Pneumomediastinum Secondary to Foreign Body Aspiration: Clinical Features and Treatment Explorement in 39 Pediatric Patients.CHINESE MEDICAL JOURNAL,129,(22)
MLA:
Yang, Xiao-Jian,et al."Pneumomediastinum Secondary to Foreign Body Aspiration: Clinical Features and Treatment Explorement in 39 Pediatric Patients".CHINESE MEDICAL JOURNAL 129..22(2016):2691-2696