儿童食管腐蚀伤并发症的诊治分析  

Analysis of diagnosing and treating complications related to esophageal corrosion in children

作　　者：谷一超 黄金狮 廖俊敏 赵勇 华凯云 李爽爽 Gu Yichao;Huang Jinshi;Liao Junmin;Zhao Yong;Hua Kaiyun;Li Shuangshuang(Department of Neonatal Surgery,Affiliated Beijing Children’s Hospital,Capital Medical University,National Center for Children’s Health,Beijing 100045,China)

机构地区：[1]国家儿童医学中心、首都医科大学附属北京儿童医院新生儿外科,北京100045

出　　处：《临床小儿外科杂志》2023年第6期554-557,共4页Journal of Clinical Pediatric Surgery

摘　　要：目的总结儿童食管腐蚀伤并发症的诊断及治疗经验。方法本研究为回顾性研究,收集2017年10月至2019年5月由首都医科大学附属北京儿童医院收治的14例食管腐蚀伤病例作为研究对象,总结患儿摄入腐蚀剂后的并发症、治疗和预后情况。结果14例患儿中,并发食管狭窄12例,其中短段食管狭窄8例,长段食管狭窄4例;14例均行胃镜下球囊扩张术,共扩张188次,有效率为66.7%(8/12),8例短段食管狭窄均扩张成功,4例长段食管狭窄扩张无效。并发食管气管瘘5例,其中3例因纽扣电池导致食管气管瘘的患儿经保守治疗后自愈。结论儿童食管腐蚀伤可造成食管狭窄,大多可经反复扩张治愈,狭窄段的长度会影响扩张治疗结果。纽扣电池所致食管气管瘘有自愈的可能,可于保守治疗失败后再行手术治疗。Objective To summarize the experiences of diagnosing and treating complications related to esophageal corrosion in children.Methods Retrospective review was conducted for clinical data of 14 children of esophageal corrosive injuries admitted from November 1,2017 to May 31,2019.The complications after ingestion of caustic agents,treatments and prognoses were recorded.Results Among them,there were 12 cases esophageal stricture,including short-segment stricture(n=8)and long-segment stricture(n=4).Endoscopy-guided balloon dilatation was employed.The total number of dilatations were 188 with a success rate of 66.7%(8/12).Group of short-segment esophageal stricture had successful dilations while group of long-segment esophageal stricture failed.Five cases of esophagotracheal fistula were complicated and 3 cases due to button battery had spontaneous closure.Conclusion For corrosive esophageal stricture in children,most cases may be cured by repeated dilatation and the length of stricture segment affects the dilatation outcomes.Esophagotracheal fistula due to button battery has the potential of spontaneous closure and surgical intervention should be performed after failed conservative measures.

关 键 词：食管 烧伤 化学 食管狭窄 气管食管瘘 诊断 治疗 治疗结果 

分 类 号：R726.5[医药卫生—儿科]