75% 的异物吸入病例发生于年龄低于 3 岁的幼儿。[6]Ramos MB, Fernandez-Villar A, Rivo JE, et al. Extraction of airway foreign bodies in adults: experience from 1987-2008. Interact Cardiovasc Thorac Surg. 2009;9:402-405.http://icvts.ctsnetjournals.org/cgi/content/full/9/3/402http://www.ncbi.nlm.nih.gov/pubmed/19491125?tool=bestpractice.com在美国,异物吸入是导致儿童意外死亡的第五大常见原因。[7]Centers for Disease Control and Prevention (CDC). Toy-related injuries among children and teenagers - United States, 1996. MMWR Morb Mortal Wkly Rep. 1997;46:1185-1189.http://www.cdc.gov/mmwr/preview/mmwrhtml/00050473.htmhttp://www.ncbi.nlm.nih.gov/pubmed/9414147?tool=bestpractice.com[8]Mantor PC, Tuggle DW, Tunell WP. An appropriate negative bronchoscopy rate in suspected foreign body aspiration. Am J Surg. 1989;158:622-624.http://www.ncbi.nlm.nih.gov/pubmed/2589600?tool=bestpractice.com美国 12% 的玩具相关伤害为误吸,5 岁以下儿童的意外死亡中 4% 为误吸,其发病高峰为一至两岁。[9]Baharloo F, Veyckemans F, Francis C, et al. Tracheobronchial foreign bodies: presentation and management in children and adults. Chest. 1999;115:1357-1362.http://journal.chestnet.org/article/S0012-3692(15)35293-4/fulltexthttp://www.ncbi.nlm.nih.gov/pubmed/10334153?tool=bestpractice.com各个国家/地区的流行病学类似。[10]Righini CA, Morel N, Karkas A, et al. What is the diagnostic value of flexible bronchoscopy in the initial investigation of children with suspected foreign body aspiration? Int J Pediatr Otorhinolaryngol. 2007;71:1383-1390.http://www.ncbi.nlm.nih.gov/pubmed/17580093?tool=bestpractice.com低收入和高收入国家/地区均会发生严重并发症(分别为 20% 和 10%),但很少有国家/地区做好系统的数据收集工作。家长和临床医生缺乏识别窒息风险的意识。[11]Foltran F, Ballali S, Rodriguez H, et al. Inhaled foreign bodies in children: a global perspective on their epidemiological, clinical, and preventive aspects. Pediatr Pulmonol. 2013;48:344-351.http://www.ncbi.nlm.nih.gov/pubmed/23169545?tool=bestpractice.com
2015 年在美国,因窒息(包括异物阻塞呼吸道)而死亡在<1 岁儿童的所有意外死亡中占 87.1% (n=1125),在成人的所有意外死亡中占 4% (n=5584)。[12]National Center for Injury Prevention and Control. WISQARS leading causes of death reports, 1999-2015. June 2015. http://webapp.cdc.gov/ (last accessed 29 August 2017).https://webappa.cdc.gov/sasweb/ncipc/leadcaus10_us.html异物吸入风险在年老患者中更高,六十至七十岁及更高年龄段的患者尤甚,原因很可能在于衰老相关的退行性神经功能紊乱和脑血管病的患病率更高,而这些疾病会造成吞咽困难和/或咳嗽反射受损。[4]Boyd M, Chatterjee A, Chiles C, et al. Tracheobronchial foreign body aspiration in adults. South Med J. 2009;102:171-174.http://www.ncbi.nlm.nih.gov/pubmed/19139679?tool=bestpractice.com[12]National Center for Injury Prevention and Control. WISQARS leading causes of death reports, 1999-2015. June 2015. http://webapp.cdc.gov/ (last accessed 29 August 2017).https://webappa.cdc.gov/sasweb/ncipc/leadcaus10_us.html[13]Smith Hammond CA, Goldstein LB. Cough and aspiration of food and liquids due to oral-pharyngeal dysphagia: ACCP evidence-based clinical practice guidelines. Chest. 2006;129(suppl 1):S154S-S168S.http://journal.chestnet.org/article/S0012-3692(15)52844-4/fulltexthttp://www.ncbi.nlm.nih.gov/pubmed/16428705?tool=bestpractice.com[14]Limper AH, Prakash UB. Tracheobronchial foreign bodies in adults. Ann Intern Med. 1990;112:604-609.http://www.ncbi.nlm.nih.gov/pubmed/2327678?tool=bestpractice.com有文献报道超过50%发生急性食物窒息的病例,患者年龄均在71至90岁之间。[15]Wick R, Gilbert JD, Byard RW. Café coronary syndrome - fatal choking on food: an autopsy approach. J Clin Forensic Med. 2006;13:135-138.http://www.ncbi.nlm.nih.gov/pubmed/16356749?tool=bestpractice.com