单中心10年儿童消化道磁性异物28例诊治分析  

Diagnosis and treatment of magnetic foreign bodies in digestive tract of children:a single center 10-year study on 28 cases

作　　者：莫优炼 胡小华[1] 张平锋[1] 钟陈[1] 冯大军[1] 苏嘉鸿 吴家成 张家德[1] Mo Youlian;Hu Xiaohua;Zhang Pingfeng;Zhong Chen;Feng Dajun;Su Jiahong;Wu Jiacheng;Zhang Jiade(Department of Pediatric Surgery,Boai Hospital of Southern Medical University,Zhongshan 528400,China)

机构地区：[1]南方医科大学附属中山市博爱医院小儿外科,广东省528400

出　　处：《中国实用医刊》2020年第19期5-9,共5页Chinese Journal of Practical Medicine

基　　金：广东省医学科学技术研究基金项目(A2017432)。

摘　　要：目的分析儿童消化道磁性异物的临床特征,提高对消化道磁性异物危害的认识,为临床治疗方案的选择提供参考。方法回顾性分析2010年1月至2019年6月南方医科大学附属中山市博爱医院收治的28例误食磁性异物患儿的构成、临床表现、诊疗过程和临床转归,并复习相关文献。结果 28例误食磁性异物的患儿年龄6个月~11岁,发病高峰期为2~3岁;病史1 h^3个月。其中20例有肠梗阻表现,形成腹内疝2例。误食磁铁数目1~23枚。自行排出5例,胃肠镜取出5例,手术取出18例,术中发现胃肠道受压未穿孔8例,胃肠道穿孔7例,形成内瘘3例。磁性异物位于食管远端、胃、十二指肠、空肠、回肠及结肠。自行排出、经胃肠镜取出患儿均顺利痊愈,手术患儿术后肠梗阻3例,2例保守治疗痊愈,1例再次手术后痊愈;肠瘘1例,再次手术后痊愈。随访至今无并发症发生。结论儿童磁性消化道异物病例越来越多见,特别是以"巴克球"为代表的磁性异物,吞食隐匿,容易导致肠梗阻、多处消化道穿孔等严重病情,需要尽早根据磁性异物的数目及位置选择合适的治疗方式;同时,应加强医务人员及家长对小儿误食多枚磁性异物的认识,尽量避免此类意外伤害。Objective To analyze the clinical characteristics of magnetic foreign bodies in children’s digestive tract,and to improve the recognition of the harm of magnetic foreign bodies in digestive tract,and to provide reference for the selection of the most appropriate clinical treatment plan.Methods The clinical data,including age distribution,clinical manifestations,diagnosis procedure and clinical outcome,from 28 children with magnetic foreign body in digestive tract treated in Boai Hospital of Southern Medical University from January 2010 to June 2019 were retrospectively analyzed.And related literature was reviewed.Results The age distribution of 28 children who ingested the magnetic foreign body by mistake was 6 months to 11 years,the peak of onset age was 2 to 3 years old;and their medical history ranged from 1 h to 3 months.There were 20 cases intestinal obstruction and 2 cases internal hernia.The number of magnets eaten by mistake was 1-23.Among them,5 patients defecated the foreign body by themselves;5 patients underwent gastroscopy to extract the foreign body;and 18 patients underwent surgery to extract the foreign body,including 8 cases with necrosis of gastrointestinal tract without perforation,7 cases with perforation of gastrointestinal tract,and 3 cases with internal fistula.Magnetic foreign bodies located in the distal esophagus,stomach,duodenum,jejunum,ileum and colon.The children who defecated the foreign body by themselves or removed it by gastroscopy were all cured successfully.Among the children who underwent surgery,3 cases had intestinal obstruction,including 2 cases cured by conservative treatment and 1 case cured by reoperation;1 case had intestinal fistula and recovered after reoperation.All cases got complete recovery after surgical treatment,and no complication occurred during follow-up.Conclusions There are more and more cases of mistaking magnetic foreign bodies in children,especially those represented by Barker ball,which is eated and concealed from the parents,resulting in intestinal o

关 键 词：儿童 磁性异物 消化道异物 

分 类 号：R725.7[医药卫生—儿科]