上消化道异物急诊内镜处理的回顾性分析  

Retrospective analysis of emergent endoscopic management of foreign bodies in the upper gastrointestinal tract

作　　者：张凌云[1] 姜艳[2] 刘颖[1] 刘佳[1] 姜永梅[3] Ling-yun Zhang;Yan Jiang;Ying Liu;Jia Liu;Yong-mei Jiang(Department of Gastroenterology;Department of Intensive Care Unit;Department of Clients’Service, the Affiliated Hospital of Qingdao University, Qingdao, Shandong 266000, China)

机构地区：[1]青岛大学附属医院消化科,山东青岛266000 [2]青岛大学附属医院重症监护室,山东青岛266000 [3]青岛大学附属医院客户服务部,山东青岛266000

出　　处：《中国内镜杂志》2017年第12期98-102,共5页China Journal of Endoscopy

摘　　要：目的展示急诊内镜下上消化道异物取出术的经验及创新的措施。方法该研究回顾性分析2013年1月-2016年11月在该院消化内镜室取出异物的251例患者,患者采取局部麻醉或静脉复合麻醉方法,应用软式内镜和各种内镜附件(鼠齿钳、鳄鱼钳、息肉勒除器、息肉抓钳、取石网篮、碎石器或者碎石工具套装和橡胶手套等)进行诊治。收集患者的一般资料(年龄、性别、异物类型)、麻醉种类、异物崁顿的位置、内镜附件的类型、并发症和成功率。结果 251例患者均通过内镜确诊为消化道异物,248例患者异物被成功取出,3例失败,其中1例患者行胸外科手术,1例行耳鼻喉科手术,1例患者因为没有症状和治疗风险而拒绝行异物取出术。192例有轻微黏膜损伤或出血,45例患者发现潜在疾病。结论急诊内镜下异物取出术是治疗消化道异物的最佳手段,因为其在安全性、有效性、费用低、微创方面有绝对优势,而且内镜治疗时还可以发现潜在消化系统疾病;创新性的手段可提高异物取出成功率。Objective To present novel measures in endoscopic removal of foreign bodies in the upper gastrointestinal tract.Methods The clinical trial performed a retrospective analysis of emergency endoscopic management of251cases of foreign bodies in the upper gastrointestinal tract from January2013to November2016.The patients underwent gastric endoscopic examinations under local pharyngeal anesthesia or general intravenous anesthesia.Flexible endoscopes and retrieval accessories such as rat-tooth and alligator forceps,polyp snares,polyp graspers,dormia basket,lithotripter or grasping forceps or rubber gloves were used for the endoscopic procedures.We reviewed of patients'general data(age,sex,type of foreign body),type of anaesthesia,foreign bodies'locations,type of accessory,complications,success rate.Results A total of251foreign bodies were definitely diagnosed through endoscopy,248foreign bodies were successfully removed with compatible devices according to the foreign bodies'location,nature,and size,and3cases failed.At the same time,192cases had little mucosal laceration and bleeding,and45cases were found to have underlying diseases.1cases had esophageal surgery and1cases had laryngeal surgery.1cases refuse to remove the foreign body because no symptoms and therapheutic risks.Conclusion Emergency endoscopic management is the foremost option for foreign bodies in the upper gastrointestinal tract,for its obvious dvantages in safety,efficiency,low cost,and minimal invasion.Endoscopic intervention can also diagnose early underlying digestive diseases.Innovative measures can increase the successful rate of removing foreign bodies with gastric endoscopy.

关 键 词：异物 胃镜 内镜处理 附件 经验 

分 类 号：R459.7[医药卫生—急诊医学]