内蒙古包头地区经内镜下治疗上消化道异物872例体会  

Experience of endoscopic treatment of 872 cases of upper gastrointestinal foreign body in Baotou,Inner Mongolia

作　　者：张静洁[1] 江振宇[1] 贾东武[1] 王晶[1] 周怡[1] 孟宪梅[1] Zhang Jingjie;Jiang Zhenyu;Jia Dongwu;Wang Jing;Zhou Yi;Meng Xianmei(Depatment of Gastroenterology,The Second Affiliated Hospital of Baotou Medical College,Baotou 014030,China)

机构地区：[1]内蒙古包头医学院第二附属医院消化科,包头014030

出　　处：《中华胃肠内镜电子杂志》2021年第4期166-170,共5页Chinese Journal of Gastrointestinal Endoscopy(Electronic Edition)

基　　金：内蒙古自然基金项目(2018MS08050)。

摘　　要：目的通过分析包头地区消化道异物特点,进一步探讨消化道异物的治疗时机及方法。方法回顾性分析2011年1月至2019年12月于包头医学院第二附属医院消化科就诊的消化道异物患者,共纳入958例,其中,自然排出体外86例、经内镜下上消化道异物治疗872例,对经内镜下治疗消化道异物临床资料进一步总结分析。结果经内镜治疗的872例患者中,其中,男475例、女397例(男女比例1.2∶1);年龄范围8个月~93岁(54.6±3.3)岁。48例(5.5%)患者合并相关上消化道疾病,食管上段异物623例(71.4%),其中食管入口处486例(78%)、胃内异物208例(23.9%)、十二指肠异物41例(4.7%);867例(99.4%)在内镜下一次性成功取出异物或送入胃内自然排出、4例患者内镜无法取出转外科手术治疗、1例患者合并感染导致死亡;756例(87.2%)异物单用异物钳、88例(10.1%)使用圈器套取出;术后伴有异物相关并发症684例(78.9%),其中416例(60.8%)为黏膜充血水肿或少量渗血等轻微并发症、96例(14%)为食管溃疡或黏膜撕裂,均未做内镜下特殊处理、16例(2.34%)出现消化道穿孔,经内科保守治疗愈合。异物取出后发现上消化道肿瘤27例,其中发现早癌6例。结论采用内镜下治疗消化道异物是种安全、经济、有效的方法。Objective To analyze the characteristics of foreign body in digestive tract in Baotou area,and to discuss the treatment time and method of foreign body in digestive tract.Methods A total of 958 patients with gastrointestinal foreign body admitted to our hospital from January 2011 to December 2019 were retrospectively analyzed,of which 86 were discharged naturally and 872 underwent enduscopic treatment.The clinical data of endoscopic treatment of gastrointestinal foreign body were further summarized and analyzed.Results Among the 872 patients treated by endoscopy,there were 475 males and 397 females(male to female ratio 1.2∶1).The age range ranged from 8 months to 93 years(54.6±3.3),and 48 patients(5.5%)were associated with upper gastrointestinal diseases.There were 623 cases(71.4%)of foreign bodies in the upper esophagus,including 486 cases(78%)at the esophageal entrance,208 cases(23.9%)in the stomach and 41 cases(4.7%)in the duodenum.In 867 cases(99.4%),foreign bodies were successfully removed or delivered to the human stomach for natural excretion in a single time under endoscopy.Four patients were unable to remove the endoscope and transferred to surgical treatment,and one patient died due to co-infection.In 756 cases(87.2%),foreign bodies were removed with foreign body forceps alone,and in 88 cases(10.1%),the foreign body was removed with a retainer sleeve.There were 684 cases(78.9%)with complications related to foreign bodies,of which 416 cases(60.8%)were minor complications such as mucosal hyperemia edema or a small amount of bleeding.96 cases(14%)were esophageal ulcer or mucosal tear,and no special endoscopic treatment was performed.16 cases(2.34%)had digestive tract perforation,which was healed by conservative treatment in internal medicine.After the foreign body was removed,27 cases of upper digestive tract tumors were found,among which 6 cases of early cancer were found.Conclusion Endoscopic treatment of foreign body in digestive tract is a safe,economical and effective method.

关 键 词：消化道异物 内镜 治疗 内蒙古 

分 类 号：R73[医药卫生—肿瘤]