食管异物109例诊治思考  

Diagnosis and treatment of 109 cases of esophageal foreign bodies

作　　者：郭思荃 张俊中 关兵 徐丽 GUO Siquan;ZHANG Junzhong;GUAN Bing;XU Li(Department of Otolaryngology Head and Neck Surgery,Northern Jiangsu People’s Hospital Affiliated to Yangzhou University,Yangzhou 225001,China;Department of Otolaryngology Head and Neck Surgery,the First People’s Hospital of Changzhou,the Third Affiliated Hospital of Soochow University,Changzhou 213004,China)

机构地区：[1]扬州大学附属苏北人民医院耳鼻咽喉头颈外科,扬州225001 [2]江苏省常州市第一人民医院(苏州大学附属第三医院)耳鼻咽喉头颈外科,常州213004

出　　处：《中国眼耳鼻喉科杂志》2021年第5期355-359,共5页Chinese Journal of Ophthalmology and Otorhinolaryngology

摘　　要：目的总结食管异物的诊治经验。方法收集2020年1月23日~4月1日在苏北人民医院急诊耳鼻喉科就诊并确诊为食管异物的患者109例,其中男性49例、女性60例;年龄16~90岁;异物存留时间0.17~192 h。异物多数为鱼刺(55/109)、骨类(32/109)、食物团块(16/109),罕见异物如假牙(2/109)、枣核(4/109)等。采用SPSS 25.0进行统计分析。结果92例患者于内镜中心行电子胃镜检查,取出异物83例,1例未取出,8例未见异物。17例患者收住耳鼻喉科,8例行全身麻醉电子胃镜检查并取出异物;9例行全身麻醉食管镜检查,取出异物7例,2例未见异物。1例患者自行至上级医院治疗,住院后在全身麻醉胃镜下取出异物。门诊治疗患者与住院治疗患者在年龄、异物存留时间及异物长度方面的差异均具有统计学意义(P值均<0.05)。所有患者均治愈出院,随访2周,恢复良好。结论电子胃镜安全有效,可作为食管异物的首选治疗方案。对于复杂食管异物需加强多学科协作,选择最优方案。Objective To summarize the diagnosis and treatment experience of esophageal foreign body.Methods One hundred and nine patients with esophageal foreign bodies accepted from January 23 to April 1st in 2020(49 cases of male and 60 cases of female)were aged from 16 to 90 years,with foreign bodies from 0.17 to 192 hours.Most of the foreign bodies were shark fins(55/109),bones(32/109)and food masses(16/109),the rare ones were false teeth(2/109)and date(4/109).SPSS 25.0 was used for statistical analysis.Results Ninety-two cases were examined by electronic gastroscopy in the endoscopy center.Eighty-three foreign bodies were successfully removed,1 failed,and 8 foreign bodies couldn’t be seen.Seventeen cases were admitted in otolaryngology department,8 cases were examed and the foreign bodies were successfully removed under electronic gastroscope;9 cases were examed under esophagoscope,in which foreign bodies in 7 cases were successfully removed and 2 foreign bodies couldn’t be seen.One case went to a superior hospital for treatment by himself.and the foreign body was removed under general anesthesia by gastroscope after hospitalization.The differences in age,foreign body retention time and foreign body length between outpatient and inpatient were statistically significant(P<0.05).All the patients were cured and discharged.The follow-up of 2 weeks showed a good recovery.Conclusions Electronic gastroscope could be a prefer method for the treatment of esophageal foreign body because of its safety and effectiveness.For complex esophageal foreign bodies,multidisciplinary collaboration should be strengthened and the optimal scheme should be selected.

关 键 词：食管异物 电子胃镜 食管镜 耳鼻咽喉头颈外科 

分 类 号：R768.32[医药卫生—耳鼻咽喉科]