Asthma: the great imitator in foreign body aspiration?
Asthma: the great imitator in foreign body aspiration?
复制标题
哮喘：异物抽吸的伟大模仿者？
DOI：
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发表时间：
2012
期刊：
影响因子：
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通讯作者：
J. Manoukian
中科院分区：
文献类型：
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作者：
J. Saliba;T. Mijović;S. Daniel;L. Nguyen;J. Manoukian
客观化
目的：确定因怀疑气管、支气管树异物吸入(FBA)而接受硬性支气管镜(RB)检查的儿童中潜在的下呼吸道炎症状况的患病率，并确定在接受诊断性支气管镜检查之前可以从抗哮喘治疗试验中受益的患者的特征。
设计
回顾图表。
设置
在蒙特利尔儿童医院接受RB手术的疑似气管-支气管树FBA的儿童(2001-2009年)。
方法
分析患者的特征，如临床、放射学和支气管镜表现，以及既往使用吸入性支气管扩张剂或皮质类固醇的情况。P值被认为是重要的。
主要结果衡量标准
吸入性支气管扩张剂或皮质类固醇的使用、体征、症状以及出现时的放射学和支气管镜检查结果。
结果
55名儿童因疑似FBA接受了RB检查。异物检出36例。哮喘组支气管镜检查阴性的可能性显著高于非哮喘组(80.0%vs30.0%，p<；0.05)。除此之外，这两组患者的临床和放射学表现没有显著差异。从可疑窒息事件到第一次耳鼻咽喉科评估，哮喘组中位时间为14天(5小时-90天)，而非哮喘组为16小时(0.5小时-120天)。
结论
对于可能患有FBA的疑似哮喘儿童，保守的方法是不合理的，他们必须为每个患者量身定做诊断支气管镜检查的适应症，以确保及时诊断。
OBJECTIVE
To determine the prevalence of underlying lower airway inflammatory conditions in children who underwent rigid bronchoscopy (RB) for a suspected foreign body aspiration (FBA) in the tracheobronchial tree and to identify the characteristics of patients who could benefit from a trial of antiasthma treatment prior to undergoing a diagnostic bronchoscopy.
DESIGN
Retrospective chart review.
SETTING
Children with suspected FBA in the tracheobronchial tree who underwent RB at the Montreal Children's Hospital (2001-2009).
METHODS
Patient characteristics such as clinical, radiologic, and bronchoscopic findings on presentation, as well as prior use of inhaled bronchodilators or corticosteroids, were analyzed. A p value < .05 was considered significant.
MAIN OUTCOME MEASURES
Use of inhaled bronchodilators or corticosteroids, signs, symptoms, and radiologic and bronchoscopic findings on presentation.
RESULTS
Fifty-five children underwent an RB for suspected FBA. Foreign bodies were found in 36 subjects. Asthmatics were significantly more likely to have a negative bronchoscopy than nonasthmatics (80.0% vs 30.0%, p < .05). Otherwise, clinical and radiologic findings were not significantly different in these two groups. The median time between the suspected choking event and the first otolaryngology evaluation was 14 days in asthmatics (range 5 hours-90 days), whereas it was 16 hours in nonasthmatics (range 0.5 hours-120 days).
CONCLUSION
A conservative approach cannot be justified in suspected asthmatic children with possible FBA, in whom the indications for diagnostic bronchoscopy must be tailored to each patient to ensure a timely diagnosis.