2例支气管异物手术失败原因分析
MODERN JOURNAL OF INTEGRATED CHINESE TRADITIONAL AND WESTERN MEDICINE(2001)
Abstract
1病例报告
例1:男,6岁,因吃炒蚕豆后呛咳2周人院.入院前在县级医院就诊,拟"右支气管异物"转入本院.体检:T 37℃,R 21次/分,右肺呼吸音消失,左肺呼吸音增强.X线透视示右肺野透光度普遍降低,左肺野透光度增高伴纵隔摆动.诊断:右支气管异物伴右肺肺不张.次日在无麻下行支气管镜检查并异物取出术,术中发现,有一黄色蚕豆异物嵌顿于右支气管内,其周围的支气管粘膜充血肿胀.用鳄鱼嘴异物钳抓住蚕豆一端,随同支气管镜一同取出,当异物通过声门时,因声门的阻挡,蚕豆与异物钳脱离并被回吸,随即支气管镜与异物钳退出气管.此时患儿出现烦躁不安,吸气性呼吸困难,吸气期三凹征,口唇青紫等缺氧症状,血氧饱和度下降.主任医师认为,迅速再行支气管镜检查,将估计吸入左侧支气管内蚕豆取出,请示院领导后决定行心肺复苏术,后抢救无效,死亡.
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