探讨硬质镜联合可弯曲支气管镜在支气管异物(bronchial foreign body)取出中的临床应用价值。

回顾性分析2010年1月至2024年6月我院收治59例支气管异物患者为对象，采用硬质镜联合可弯曲支气管镜取出患者异物。收集临床资料，比较支气管异物种类、位置、镜下表现、异物取出方式及预后。

59例支气管异物患者中男41例，女18例，年龄2~87岁，异物最长时间27年，最短时间1 d，临床表现为反复肺炎16例(27.12%)，咯血6例(10.17%)，无症状影像发现8例(13.56%)，镜下伴气道不同程度狭窄58例(98.31%)，不伴狭窄1例(1.69%)。异物种类包括骨性异物18例，植物性异物17例(辣椒、花生米、瓜子、黄豆)，金属5例(唢呐嘴，长形钢钉)，塑料5例(哨子、圆珠笔帽)，牙齿或义齿4例，药片、药物胶囊2例，医用胶、耳塞及活性炭各1例，不明性质异物5例，其中最长异物为鱼骨，达6.0 cm。经胸部CT及可弯曲支气管镜检查明确诊断，成功取出58例(98.31%)，未取出1例。58例中使用一种介入手段取出41例，包括活检钳21例、二氧化碳冻取4例、圈套器8例、异物钳4例、异物网篮3例，硬质钳2例；使用两种介入手段取出14例，三种及以上介入手段取出4例。

应用硬质镜联合可弯曲支气管镜下治疗支气管异物，可快速清除异物，缓解气道狭窄，改善患者临床症状，高效、安全、成功率高，具有临床应用前景。

To investigate the clinical application value of rigid bronchoscopy combined with flexible bronchoscopy in the removal of bronchial foreign bodies.

A retrospective analysis was conducted on 59 patients with bronchial foreign bodies admitted to our hospital from January 2010 to June 2024. Foreign bodies were removed using rigid bronchoscopy combined with flexible bronchoscopy. Clinical data were collected to compare the types, locations, endoscopic findings, removal methods, and prognosis of the bronchial foreign bodies.

Among the 59 patients, there were 41 males and 18 females, aged 2 to 87 years. The longest duration of a foreign body was 27 years, and the shortest was 1 day. Clinical presentations included recurrent pneumonia in 16 cases (27.12%), hemoptysis in 6 cases (10.17%) and asymptomatic discovery via imaging in 8 cases (13.56%). Endoscopy revealed varying degrees of airway stenosis accompanying the foreign body in 58 cases (98.31%), with no stenosis in 1 case (1.69%). Types of foreign bodies included bony objects in 18 cases, plant-based objects in 17 cases (chili pepper, peanut, melon seed, soybean), metal objects in 5 cases (suona mouthpiece, long steel nail), plastic objects in 5 cases (whistle, ballpoint pen cap), teeth or dentures in 4 cases, pills/drug capsules in 2 cases, and medical glue, earplug, and activated charcoal in 1 case each. Five cases involved foreign bodies of unknown nature. The longest foreign body was a fish bone, measuring 6.0 cm. Diagnosis was confirmed by chest CT and flexible bronchoscopy. Successful removal was achieved in 58 cases (98.31%), with 1 case not removed. Among the 58 successful cases, a single interventional technique was used in 41 cases: biopsy forceps 21 cases, cryoextraction with CO₂ 4 cases, snare 8 cases, foreign body forceps 4 cases, foreign body basket 3 cases, rigid forceps 2 cases. Two interventional techniques were used in 14 cases, and three or more techniques were used in 4 cases.

The application of rigid bronchoscopy combined with flexible bronchoscopy for the treatment of bronchial foreign bodies allows for rapid removal, alleviation of airway stenosis, and improvement of clinical symptoms. It is efficient, safe, has a high success rate, and holds promising clinical application prospects.