下消化道食源性异物14例诊治分析  

Clinical diagnosis and treatment for food-borne foreign body in lower digestive tract

作　　者：姚宗浠[1] 刘玉林 屠俊浩 Yao Zongxi;Liu Yulin;Tu Junhao(Department of General Surgery,Suzhou Wuzhong People’s Hospital,Jiangsu,Suzhou 215128,China)

机构地区：[1]江苏苏州市吴中人民医院普外科,苏州215128

出　　处：《河南外科学杂志》2022年第1期4-6,共3页Henan Journal of Surgery

摘　　要：目的探讨下消化道食源性异物的诊断和治疗方法。方法回顾性分析2017-01—2020-12苏州市吴中人民医院普外科收治的14例下消化道食源性异物患者的临床资料,总结异物类型、位置、临床表现、治疗方法及预后。结果14例食源性异物中,枣核6例,鱼骨5例,鸡骨1例,甲鱼骨1例,鱼钩1例。出现临床症状者12例(急腹症6例、肛门口异物感5例、排便次数增多1例),无临床症状2例;异物位于空肠下段1例,回肠5例,盲肠3例,肛管5例。2例行腹腔镜手术治疗,4例行开腹手术治疗,3例行内镜治疗,2例行肛门镜手术治疗,3例在门诊直视下使用血管钳取出。3例发生术后并发症(1例腹壁切口疝、1例粘连性肠梗阻、1例肛周脓肿),均经对症治疗后痊愈。结论下消化道食源性异物患者在吞入异物的初期多无临床表现,因起病隐匿、无法明确异物性质,或遗忘误食史,易导致误诊而引发严重并发症。故需充分认识食源性下消化道异物患者的临床表现及危害性,积累诊治经验,及时进行有关检查,并根据异物的类型、位置,个体化选择治疗方法。Objective To provide clinical diagnosis and treatment experience by analyzing and summarizing the clinical diagnosis and treatment of foodborne foreign bodies in the lower digestive tract.Methods Totally 14 cases of lower gastrointestinal foreign bodies were studied retrospectively,and the type,clinical presentation,location,treatment and prognosis were analyzed.Results Among the 14 cases,Six cases of jujube nucleus,5 fish bone,1 chicken bone,1 turtle bone,1 fish hook,12 clinical symptoms(6 acute abdomen,1 defecation,5 foreign body in jejunal section),5 ileac section 3 patients appendix,5 anal canal,2 laparoscopic surgery,3 endoscopic treatment,2 anoscopic surgery,and 3 using forceps removed directly at consulting room;Three postoperative complications(one abdominal wall incision hernia,one cohesive intestinal obstruction,and one perianal abscess)they were all recovered after treatment.Conclusion The lower digestive tract has no clinical manifestations in the early stage of swallowing,and the patient cannot clarify the nature or forget the history of misfood,and has hidden onset and easy misdiagnosis,which is challenging for clinical diagnosis and treatment.Full understanding of food-borne lower digestive tract foreign bodies has guiding value for the clinical diagnosis and treatment of similar diseases.

关 键 词：下消化道 食源性异物 临床诊疗 

分 类 号：R57[医药卫生—消化系统]