| Abstract | Ciljevi: Glavni ciljevi ovog istraživanja bili su odrediti postotak pronađenih i uspješno odstranjenih stranih tijela prilikom traheobronhoskopije, kao i njihovu vrstu i lokalizaciju te utvrditi postoji li razlika u demografskim, kliničkim i radiološkim obilježjima među skupinama s i bez stranog tijela. Ispitanici i metode: Provedena je retrospektivna studija u koju je uključeno 62 ispitanika kojima je u KBC-u Split učinjena traheobronhoskopija zbog sumnje na aspiraciju stranog tijela, u razdoblju od 1.1.2010. do 31.12.2020. Prikupljeni podatci za svakog ispitanika uključivali su: dob, spol, nalaz traheobronhoskopije, radiološke nalaze i kliničke podatke. Ovisno o nalazu traheobronhoskopije, ispitanici su podijeljeni u dvije skupine: skupina s potvrđenim stranim tijelom (n=32) i skupina u kojoj strano tijelo nije pronađeno (n=30). Rezultati: Strano tijelo pronađeno je u 32 (51,6%) bolesnika kojima je učinjena traheobronhoskopija, a uspješno je odstranjeno njih 31 (96,9%). Medijan dobi u skupini s potvrđenim stranim tijelom iznosio je 20,5 mjeseci (15,3-35,5). Najveća incidencija 19 (59,4%) bila je u dobi između 1 i 3 godine. U skupini s potvrđenim stranim tijelom (n=32) dječaci čine većinu 22 (68,8%) u odnosu na djevojčice 10 (31,2%) u omjeru 2,2:1. Većina stranih tijela bila je organskog podrijetla (87,5%), a najčešće pronađeno strano tijelo bilo je kikiriki (37,5%). Strano tijelo je bilo lokalizirano podjednako u desnom glavnom bronhu (43,75%) kao i u lijevom (43,75%), u oba glavna bronha bilo je 3,1% stranih tijela, a u dušniku 9,4%. Korištenje pomoćne dišne muskulature (P=0,024), auskultacijski smanjen šum disanja (P=0,001), dispneja (P=0,046), emfizem (P=0,011) i pomak medijastinuma (P=0,011) statistički su značajno češći u skupini s potvrđenim stranim tijelom. Netransparentno strano tijelo bilo je prisutno u 9,4% bolesnika kojima je strano tijelo potvrđeno, a 46,9% imalo je uredan nalaz RTG-a prsnog koša. Zaključci: Liječnici bi trebali imati veću razinu sumnje na aspiraciju stranog tijela u slučajevima kada se bolesnik prezentira dispnejom, korištenjem pomoćne dišne muskulature, auskultacijski smanjenim šumom disanja te emfizemom i pomakom medijastinuma na RTG-u prsnog koša. Edukacija i podizanje razine svijesti javnosti ključni su za prevenciju aspiracije stranog tijela. |
| Abstract (english) | Objectives: The main objectives of this study were to determine the percentage of foreign bodies found and successfully removed during tracheobronchoscopy, as well as their type and location. Additional aim was to determine whether there is a difference in demographic, clinical and radiological characteristics between groups with and without foreign body. Patients and methods: A retrospective study in which we included 62 patients who underwent tracheobronchoscopy due to suspicion of foreign body aspiration was conducted in the period from the 1th of January 2010 to the 31th of December 2020 in University Hospital of Split. Data collected for each patient included: age, sex, tracheobronchoscopy finding, radiological findings, and clinical data. Depending on the tracheobronchoscopy finding, patients were divided into two groups: confirmed foreign body (n = 32) and no foreign body found (n = 30). Results: A foreign body was found in 32 (51.6%) patients who underwent tracheobronchoscopy, and 31 (96.9%) of them were successfully removed. The median age in the group with a confirmed foreign body was 20.5 months (15.3-35.5). The highest incidence of 19 (59.4%) was between 1 and 3 years of age. In the group with a confirmed foreign body (n = 32), boys make up a majority of 22 (68.8%) compared to girls 10 (31.2%) in a 2.2: 1 ratio. Most foreign bodies were of organic origin (87.5%) and the most commonly found foreign body was peanuts (37.5%). The foreign body was localized equally in the right main bronchus (43.75%) as in the left (43.75%), in both main bronchi there were 3.1% of foreign bodies, and in the trachea 9.4%. Use of accessory respiratory muscles (P=0.024), auscultatory reduced breathing sound (P=0.001), dyspnoea (P=0.046), emphysema (P=0.011), and mediastinal shift (P=0.011) were statistically significantly more common in the group with confirmed foreign body. A non-transparent foreign body was present in 9.4% of patients with a confirmed foreign body and 46.9% of patients with a confirmed foreign body had a normal chest X-ray finding. Conclusions: Physicians should have a higher level of suspicion for foreign body aspiration in cases where the patient presents with dyspnoea, use of accessory respiratory muscles, auscultatory reduced breathing sound, and emphysema or mediastinal shift on chest X-ray. Education and raising public awareness are the key for preventing foreign body aspiration. |
