误吞磁性消化道异物住院患儿153例临床特点分析  

Clinical characteristics of 153 cases of children mistakenly swallowing magnetic digestive tract foreign body

作　　者：王华[1] 张含花[1] 刘欢宇 邵佩 任晓侠[1] 侯崇智[2] 南丹 闫楠 方莹[1] Wang Hua;Zhang Hanhua;Liu Huanyu;Shao Pei;Ren Xiaoxia;Hou Chongzhi;Nan Dan;Yan Nan;Fang Ying(Department of Gastroenterology,Xi′an Children′s Hospital,Xi′an 710003,China;Department of General Surgery,Xi′an Children′s Hospital,Xi′an 710003,China)

机构地区：[1]西安市儿童医院消化内科,陕西西安710003 [2]西安市儿童医院普外科,陕西西安710003

出　　处：《中华胃肠内镜电子杂志》2023年第4期248-252,共5页Chinese Journal of Gastrointestinal Endoscopy(Electronic Edition)

基　　金：西安市创新能力强基计划-医学研究项目(22YXYJ0081);西安市儿童医院院级课题重点项目-医联体项目(2022E01)

摘　　要：目的研究儿童误吞磁性消化道异物的临床特征,分析危险因素,以期寻求有效预防措施及优化治疗方案。方法回顾性分析2015年1月至2021年12月西安市儿童医院因误吞磁性异物住院的患儿病例资料。结果153例误吞磁性异物患儿中以男性居多(68.6%),幼儿期及学龄前期多发,年龄波动在6个月~14岁龄,住院人数及接受外科手术人数呈逐年递增趋势;误吞磁性异物数量不等(1~60枚)、异物类型不同,其中85%患儿误吞多枚磁性异物或磁性异物合并金属异物;85例(55.6%)患儿行外科手术干预,临床症状以腹痛为主,其中81例存在消化道瘘,以小肠-小肠瘘最为多见(50.6%);与低年龄组相比,高年龄组发生并发症OR值为2.280(95%CI:1.155~4.501);与其他类型异物相比,误吞磁珠巴克球并发症OR值为30.816(95%CI:7.291~130.254);有临床症状、就诊时间>1 d等因素均显著增加并发症发生风险(P<0.05)。结论误吞磁性异物容易引起消化道穿孔等严重并发症,早发现、早诊断、早治疗尤为重要。误吞后24 h内行急诊胃镜为首选治疗方式,若24 h以上多次动态监测X片磁性异物位置未移动,如有临床症状,应及时行外科手术。此外,也应分年龄段、多方采取综合预防措施以降低发生率。Objective To study the clinical characteristics of children swallowing magnetic digestive tract foreign bodies by mistake and analyze the risk factors,so as to seek effective preventive measures and optimize the treatment plan.Methods Retrospective analysis was performed on the case data of children hospitalized for swallowing magnetic foreign bodies by mistake in Xi'an Children's Hospital from January 2015 to December 2021.Results Among the 153 cases of children who mistakenly swallowed magnetic foreign bodies,most of them were male(68.6%),mostly in early childhood and early school age,and the age fluctuated from 6 months to 14 years old.The number of hospitalizations and the number of surgical operations showed an increasing trend year by year.The number of mistakenly swallowed magnetic foreign bodies varied(1-60),and the types of foreign bodies were different.85%of patients mistakenly swallowed multiple magnetic foreign bodies or magnetic foreign bodies combined with metal foreign bodies.Eighty-five patients(55.6%)underwent surgical intervention,and the main clinical symptoms were abdominal pain,among which 81 patients had digestive tract fistula,and entero-enteric fistula was the most common(50.6%).compared with the low age group,the OR value of complications in the high age group was 2.280(95%CI:1.155-4.501);Compared with other types of foreign bodies,the OR of buckball complications caused by swallowing magnetic beads by mistake was 30.816(95%CI:7.291-130.254).The presence of clinical symptoms and the time of treatment>1 day significantly increased the risk of complications(P<0.05).Conclusion Swallowing magnetic foreign bodies can easily cause serious complications such as digestive tract perforation,thus early detection,diagnosis and treatment are particularly important.Emergency gastroscopy within 24 hours after misingestion is the preferred treatment.If the location of magnetic foreign bodies on X-ray is not moved after multiple dynamic monitoring for more than 24 hours,surgery should be performed in tim

关 键 词：儿童 消化道磁性异物 临床特点 治疗 

分 类 号：R72[医药卫生—儿科]