经可弯曲支气管镜持续负压吸引对儿童气道异物取出的效应分析

Objective To explore the specific operation process, safety and effectiveness of continuous negative pressure suction through flexible bronchoscope for removal foreign bodies in children's airway. Methods Retrospective case summary: Clinical data of all children with bronchial foreign bodies at the Children's Respiratory Endoscopy Center of Shanghai Children's Medical Center Guizhou Hospital/Guizhou Provincial People's Hospital from October 2021 to August 2024(a total of 30 cases) were collected. According to the method of foreign body removal, they were divided into two groups: one group used continuous negative pressure suction for foreign body removal, and the other group used other methods(including forceps, baskets, cryotherapy) for foreign body removal. Compare the differences in clinical characteristics between the two groups of children. Quantitative data are described as M(Q1, Q3), and the comparison between groups was conducted using the Mann-Whitney U test. Count data are expressed as [n(%)], and the comparison between groups was performed using the χ2 test. The surgical duration, incidence of intraoperative adverse reactions, postoperative complications, postoperative hospital stay, and hospitalization cost of the two methods of removing foreign bodies were compared to explore the safety and effectiveness of negative pressure suction for foreign body removal. At the same time, specific negative pressure suction operation procedures were provided. Results Among the 30 children with foreign bodies, 20 were male(67%) and 10 were female(33%), with ages ranging from 1 year to 11 years(average age approximately 2.9 years); 23 cases were under 3 years old, accounting for 76.7%. The other extraction methods group was compared with the continuous negative pressure suction group: age(y): 1(1.0, 2.0): 6.5(3.75, 7.75), P = 0.015; gender: male/female were 18/6 and 2/4 respectively, P = 0.076; weight(kg): 11.3(10.0, 13.3): 23.0(16.75, 24.75), P = 0.011; foreign body retention time(d): 10.0(7.0, 20.0): 10.5(7.75, 14.0), P = 0.900; operation duration(min): 23.5(15.0, 33.0): 31.5(30.0, 45.5), P = 0.191; total hospitalization cost(yuan): 8829(7583.5, 10464): 13698(13639, 14307.75), P = 0.251; postoperative hospital stay days: 4(2, 5.25): 6(2.75, 8.5), P = 0.432; surgical complications: the other extraction method group had 1 case of mucosal swelling, 1 case of hypoxemia, 2 cases of a small amount of bleeding during the operation, totaling 4 cases; the negative pressure suction group had 1 case of a small amount of bleeding during the operation, no other complications occurred. At the same time, we proposed that when extracting foreign bodies with continuous negative pressure suction, the foreign body should be tightly attached to the front end of the lens, at this time, the image displayed on the screen is a pure white, and the most suitable negative pressure value is(-0.06 MPa). Conclusion This study presents a method for continuous negative pressure aspiration to remove airway foreign bodies, which is both practical, safe and effective, and is suitable for clinical application.