Abstract:

Objective    To review the cases of accidental aspiration and ingestion of foreign objects during dental procedure，and to discuss and summarize the prevention and treatment measures. Methods    A comprehensive search on such key words as dental procedure/treatment/practice，aspiration/inhalation，and ingestion/swallow was performed in the literature before October lst 2014 available. The statistical analyses were made on the variables including journals and reported year，patients′ gender，age，general conditions，dental procedure and location for treatment，foreign objects，site of involvement，possible causes，symptoms，treatment time and treatment modality，and follow-up results. Results    A total of 628 cases reported by 46 articles from 38 kinds of journals were included and analyzed. Analysis showed that aspiration and ingestion were more seen in patients at 60 ~ 79 years old and 10 ~ 19 years old. Only 12 cases were reported with systemic disease. Most cases happened at general dental clinic. Aspiration and ingestion happened mostly during implantation and prosthodontics. Endodontic file and screwdriver were the most common objects aspirated and ingested. The foreign objects were more found at bronchus and stomach， respectively. Only one third of the cases mentioned the causes. Nearly half of the aspirated cases and a few ingested cases had symptom when the accident happened. Most aspirated cases and half of the ingested cases had the foreign objects removed by intervention. Only 1 case had acute airway obstruction after removal of the object. Conclusion    Although aspiration and ingestion of foreign objects are rare during dental procedure，every dental personnel should attach importance to prevention and treatment in order to avoid and reduce the occurrence of such accidents.

Key words: aspiration, ingestion, foreign objects, dental procedure

摘要：

目的    回顾文献报道的牙科操作中的误吸误咽病例，探讨总结误吸误咽的治疗与预防措施。方法    针对关键词“dental procedure/treatment/practice”、“aspiration/inhalation”和“ingestion/swallow”进行2014-10-01前的文献检索。对发表期刊、时间，患者性别、年龄、全身状况，所进行的牙科操作、操作场所，异物种类、累及部位，出现误吸误咽的可能原因、出现后症状，治疗时间、方法，以及随访结果等进行系统回顾性分析。结果    38本期刊的46篇文章报道病例628例，分析数据显示，60 ~ 79岁和10 ~ 19岁是发生误吸误咽最多的年龄段。只有12例报道患有系统性疾病，种植和修复治疗时发生例数最多，根管锉、种植体螺丝及其扳手是最多见异物，多累及支气管或胃内。只有1/3病例报道了原因。发生意外后，约1/2误吸病例和少数误咽病例出现了症状。大多数误吸病例和约1/2误咽病例通过内镜介入方法取出异物，只有1例误吸病例在异物取出后出现急性呼吸梗阻。结论    尽管牙科操作中发生误吸误咽非常少见，但每一位牙科医护人员都应该重视预防和治疗，避免和减少意外发生。

关键词: 吸入, 吞咽, 异物, 牙科操作