Respiratory foreign body
Introduction
Introduction to respiratory foreign bodies Foreign body inrespiratorytract refers to the foreign body of the larynx, trachea and bronchus. It is one of the critical diseases of the otolaryngology department. It directly threatens the life of the patient, especially the foreign body with a large throat or trachea. It can block the airway and produce acute asphyxia or suddenness. death. Foreign bodies in the respiratory tract occur mostly in children under 5 years of age, and most of them are 1 to 3 years old. If some foreign bodies are misdiagnosed and treated, serious complications will occur, even life-threatening. basic knowledge The proportion of illness: 0.002% Susceptible population: occurs in children under 5 years old Mode of infection: non-infectious Complications: lung abscess
Cause
Respiratory foreign body cause
1, children like to tease the small things in the mouth, the teeth have not yet been born, can not chew food, plus cough reflection is not perfect, every time crying, laughing, scared when suddenly inhaled, a little careless to inhale the respiratory tract.
2, the foreign body itself is smooth, the body is small and light, such as melon seeds, peanuts, beans, small rubber caps, plastic caps, etc. are easy to inhale the respiratory tract.
3, bad habits at work, such as shoemakers will pin, studs, buttons, etc. between the teeth, even accidentally, or suddenly talk about the inhalation of foreign bodies, in addition, in vomiting, anesthesia, poisoning or suffering from nerves It is also caused by the disease, so that the throat reflex can be inhibited. When the upper respiratory tract is operated, the instrument parts are detached or the tissue is removed. The instrument is occasionally inhaled when the upper root canal is treated.
Prevention
Respiratory foreign body prevention
1, it is best not to eat seeds, peanuts, beans and other food for children under the age of five. When you eat watermelon, you can remove the seeds and eat them to avoid laughing, crying or snoring. It is necessary to get rid of the bad habit of eating while eating and eating, so as not to cry into the lower respiratory tract once the fall. Careful attention to children, education for older children, do not feed children with melon seeds, peanuts, beans and other foods, but also beware of children to take the above food.
2, educate children not to put small toys in the mouth, find that children in the mouth to take things in time to try to take out, but must not forcefully seize, so as not to inhale after crying.
3. Adults should change the habit of biting needles, nails, etc. in their mouths during work to prevent accidents. For patients who are unconscious after coma or general anesthesia, care should be taken: remove the dentures that have been shaken beforehand. When vomiting, the head should be turned to one side to prevent vomit from inhaling the lower respiratory tract.
Complication
Respiratory foreign body complications Complications lung abscess
Once the foreign body enters the bronchus, the chance of being coughed out is very small. The foreign body stays in the lung for too long, not only is not easy to take out, but also causes serious diseases such as tracheal inflammation, lung atrophy, lung abscess, etc. Therefore, all foreign bodies are known. Invade the trachea, and if there is no suffocation, even if there is no performance of any breathing disorder, you should go to the hospital for examination as soon as possible.
Symptom
Respiratory foreign body symptoms Common symptoms Shortness of breath, cough, hoarseness, respiratory tract, narrow nails, large longitudinal stripes... Dysphagia, thyroid cartilage can be touched...
When foreign bodies enter the lower respiratory tract, there is a severe cough. There are often asymptomatic periods of long or short, so it is easy to be misdiagnosed. Due to the nature of foreign bodies, the remaining parts and shapes are different, the symptoms are also different.
(1) Foreign body in larynx
When a foreign body enters the throat, it immediately causes cough, shortness of breath, and reflexive throat, which causes inhalation dyspnea and wheezing. If the foreign body stays in the mouth of the throat, there is hoarseness or difficulty in swallowing. If the foreign body is slightly blocked, The glottis can be immediately suffocated to death.
(2) Foreign body in trachea
The foreign body has just inhaled, and its symptoms are similar to those of the laryngeal foreign body. It is mainly cough. Later, the active foreign body moves with the airflow, which may cause paroxysmal cough and difficulty in breathing. At the end of exhalation, the foreign body can be heard at the trachea. The slap sound in the lower part of the glottis, and the impact of the foreign body on the thyroid cartilage can be touched. Because the tracheal cavity is occupied by foreign objects, or the edema under the glottis is narrow, it causes difficulty in breathing and can cause wheezing.
(three) bronchial foreign body (foreign body in bronchi)
Early symptoms are similar to tracheal foreign bodies. Different kinds of foreign bodies can have different symptoms. Plant foreign bodies, such as peanuts and beans, contain free fatty acid and oleic acid, which are highly irritating to mucous membranes. They often have high fever, cough and pus Acute bronchitis symptoms such as sputum; if it is a metal foreign body, it is less irritating to the local area. If it does not block, it may remain in the bronchi for several months without symptoms. Later, due to the intrusion of foreign bodies into the bronchus, different degrees of obstruction occurred and different symptoms appeared.
1. The bronchus is not completely blocked. When the inhalation, the trachea is enlarged, the air can enter. When exhaling, the bronchi is reduced, and the exhaled breath is less. The gas at the distal end of the obstruction is continuously increased, and obstructive emphysema is formed.
2, the bronchus is completely blocked, exhaled, the air can not pass when inhaling, then the distal air at the obstruction is gradually absorbed by the lungs, and finally forms obstructive atelectasis.
Examine
Respiratory foreign body inspection
1, X-ray inspection.
2, bronchoscopy.
Diagnosis
Diagnosis and identification of foreign bodies in the respiratory tract
diagnosis
Detailed medical history is the most important, and careful physical examination and X-ray examination are important means for diagnosing foreign bodies.
If there is a history of foreign body inhalation, or suspected foreign body inhalation history, patients with no signs, or negative X-ray examination, or bronchial obstruction with no obvious cause and acute and chronic pneumonia and atelectasis should be considered as bronchial tubes. Mirror examination to further confirm the diagnosis.
Differential diagnosis
Because the foreign body in the respiratory tract is mostly children, when the foreign body is inhaled, the family may not see it, and the child can't complain of it. The history of foreign body inhalation can not be asked. The child is often diagnosed as "asthmatic bronchitis" because of the wheezing sound. Or misdiagnosed as "pertussis" due to paroxysmal cough, or misdiagnosis of "pneumonia" and "bronchodilation" due to long-term respiratory infection. Therefore, there are localized lesions in the lungs of children, long-term unhealed or good-time offenders. The so-called "three unlike" symptoms are neither lung tuberculosis nor typical bronchial pneumonia, nor other lung diseases. In all cases, the possibility of foreign bodies in the respiratory tract should be considered and should be taken seriously. A detailed physical examination and X-ray examination are important means for diagnosing foreign bodies.
