인천 지역 소아에서 기도 내 이물 흡인의 임상적 고찰
Clinical characteristics of foreign body aspiration in children in Incheon city, Korea
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Purpose: Foreign body aspiration in children is emergent and can cause serious complications. This study aims to show the clinical characteristics of foreign body aspiration and to analyze the clinical cases of delayed diagnosis to predict and prevent complications. Methods: We retrospectively reviewed the medical records of 63 children (48 in Inha University Hospital and 15 in Gachon University Gil Medical Center) who were diagnosed with foreign body aspiration through bronchoscopy from 1996 to 2017 in Incheon City, and analyzed clinical characteristics. Patients were divided into 3 groups: those were diagnosed within 24 hours, delayed after 24 hours, or delayed more than 7 days according to time elapse from the time of foreign body aspiration, and clinical characteristics of each group were compared. Results: Aspiration occurred in 58.7% at 1 year and 15.9% at 2 years. Cough (65.1%) and coarse breathing sound (41.3%) were most common, and radiologic findings were commonly presented as emphysema on the affected side (41.3%). Nuts were most common (42.9%), and there was no difference in the frequency between the right and left main bronchi. The documented history of foreign body aspiration was more frequently found in the early diagnosed group; however, sputum, fever, and complications were more frequent in the delayed diagnosed group. Conclusion: If a patient with respiratory disease has persistent fever or sputum, foreign body aspiration should be suspected.
Abstract
Purpose: Foreign body aspiration in children is emergent and can cause serious complications. This study aims to show the clinical characteristics of foreign body aspiration and to analyze the clinical cases of delayed diagnosis to predict and prevent complications. Methods: We retrospectively reviewed the medical records of 63 children (48 in Inha University Hospital and 15 in Gachon University Gil Medical Center) who were diagnosed with foreign body aspiration through bronchoscopy from 1996 to 2017 in Incheon City, and analyzed clinical characteristics. Patients were divided into 3 groups: those were diagnosed within 24 hours, delayed after 24 hours, or delayed more than 7 days according to time elapse from the time of foreign body aspiration, and clinical characteristics of each group were compared. Results: Aspiration occurred in 58.7% at 1 year and 15.9% at 2 years. Cough (65.1%) and coarse breathing sound (41.3%) were most common, and radiologic findings were commonly presented as emphysema on the affected side (41.3%). Nuts were most common (42.9%), and there was no difference in the frequency between the right and left main bronchi. The documented history of foreign body aspiration was more frequently found in the early diagnosed group; however, sputum, fever, and complications were more frequent in the delayed diagnosed group. Conclusion: If a patient with respiratory disease has persistent fever or sputum, foreign body aspiration should be suspected.
참고문헌 (24)
- 김철민, "단일병원에서 관찰한 최근 10년간의 소아 우발사고에 관한 연구 : 이물흡인을 중심으로", Clinical and Experimental Pediatrics, 45(9), pp.1134~1140 (2002), 대한소아청소년과학회
- 손진아, "기도 내 이물 흡인 108례의 진단 및 임상경과", Allergy Asthma & Respiratory Disease, 17(2), pp.117~126 (2007), 대한 소아알레르기 호흡기학회
- Reilly JS, "Prevention and management of ae-rodigestive foreign body injuries in childhood", Pediatr Clin North Am, 43, pp.1403~1411 (1996)
- Hammer J, "Acquired upper airway obstruction", Paediatr Respir Rev, 5, pp.25~33 (2004)
- Brown TC, "Inhaled foreign bodies in children", Med J Aust, 2, pp.322~326 (1983)
- Rodriguez H, "Management of foreign bodies in the airway and oesophagus", Int J Pediatr Otorhinolaryngol, 76(Suppl 1), pp.S84~S91 (2012)
- 강성희, "소아의 기도 내 이물 흡인 48예: 임상 증상 및 경과", Allergy Asthma & Respiratory Disease, 4(2), pp.107~113 (2016), 대한 소아알레르기 호흡기학회[DOI]
- Pasaoglu I, "Bronchoscopic removal of foreign bodies in children: retrospective analysis of 822 cases", Thorac Cardiovasc Surg, 39, pp.95~98 (1991)
- Chiu CY, "Factors predicting early diagnosis of foreign body aspiration in children", Pediatr Emerg Care, 21, pp.161~164 (2005)
- Williams HE, "The "missed" inhaled foreign body in children", Med J Aust, 1, pp.625~628 (1969)
- Jeong JH, "Clinical characteristics of long-standing foreign body in airway", J Korean Pediatr Soc, 42, pp.186~194 (1999)
- 김혜영, "단일 병원에서 소아 기도 이물 흡인에 대한 30년의 임상 경험", Allergy Asthma & Respiratory Disease, 19(4), pp.383~391 (2009), 대한 소아알레르기 호흡기학회
- Jeon GR, "A clinical study of foreign body aspiration in children in suwon-kyungki province", Pediatr Allergy Respir Dis, 10, pp.225~232 (2000)
- Passali D, "Foreign body injuries in children: a review", Acta Otorhinolaryngol Ital, 35, pp.265~271 (2015)
- Lee BH, "A clinical study of foreign body aspiration into the airway of children", Pediatr Allergy Respir Dis, 5, pp.81~88 (1995)
- Ibrahim Sersar S, "Inhaled foreign bodies: management according to early or late presentation", Eur J Cardiothorac Surg, 28, pp.369~374 (2005)
- Gregori D, "Foreign bodies in the ears causing complications and requiring hospitalization in children 0-14 age: results from the ESFBI study", Auris Nasus Larynx, 36, pp.7~14 (2009)
- Leiten EO, "Complications and discomfort of bronchoscopy: a systematic review", Eur Clin Respir J, 3, pp.33324~ (2016)
- Even L, "Diagnostic evaluation of foreign body aspiration in children: a prospective study", J Pediatr Surg, 40, pp.1122~1127 (2005)
- Park JH, "Analysis of foreign body in the children’s airway and follow-up study", J Korean Pediatr Soc, 36, pp.169~177 (1993)
- Davies H, "Long term follow up after inhalation of foreign bodies", Arch Dis Child, 65, pp.619~621 (1990)
- "Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 31-1998. An eight-year-old boy with bronchiectasis", N Engl J Med, 339, pp.1144~1151 (1998)
- Karakoç F, "Foreign body aspiration: what is the outcome?", Pediatr Pulmonol, 34, pp.30~36 (2002)
- Wiseman NE, "The diagnosis of foreign body aspiration in childhood", J Pediatr Surg, 19, pp.531~535 (1984)