关键词: 误诊, 异物, 支气管, 支气管镜检查, 肉芽肿, 异物

Abstract: Objective To analyze the clinical data of 20 young and middle-aged patients with bronchial foreign bodies who were hospitalized because of unknown lung shadow. Methods The clinical data of 20 confirmed cases, including history of aspiration, imaging examination results, bronchoscopy findings and therapeutic process were retrospectively analyzed. The outcome of bronchial foreign body granuloma in the airway was observed. Results ⑴100% of the 20 patients with an average age of (46.39±3.26) years were misdiagnosed before bronchoscope examination. (2) The results of chest CT showed that the 20 patients had bronchial stenosis or obstruction with pulmonary consolidation or atelectasis, of which 18 cases were on the right side and 2 on the left side. (3) According to the shape and size of the foreign bodies as well as the length of time of aspiration, the bronchial openings were blocked by foreign bodies in 10 patients, and the foreign bodies were taken out by foreign body forceps. The diagnosis was confirmed in 3-6 (average 4.40±0.92) months in 10 patients. Four patients were obstructed by foreign bodies and granulation tissue, which took 5-12 (average 8.25±2.86) months to diagnose, while in 6 cases, masses were found in tracheal cavity, which took 6-15 (average 10.17±2.85) months to diagnose. The latter 10 (4+6) patients were treated with endotracheal intubation to remove foreign bodies and granulation tissue. (4) After 24-72 hours of treatment, the symptoms of cough, expectoration and blood in the sputum were relieved, and no severe complications occurred in 20 patients. (5) About two weeks after bronchial foreign bodies were removed, the granulation tissue disappeared. Conclusion Foreign body aspiration on the right side is more common in the 20 young and middle-aged patients, and bronchoscope is the best means of diagnosis and treatment.

Key words: diagnostic errors, foreign bodies, bronchi, bronchoscopy, granuloma, foreign-body