患有异食癖的智障患者吞食乙烯基手套的危害：对手术管理的新启示。
The hazards of vinyl glove ingestion in the mentally retarded patient with pica: new implications for surgical management.
作者信息
Kamal I, Thompson J, Paquette D M
机构信息
Department of Surgery, Queen's University, Kingston, Ont.
出版信息
Can J Surg. 1999 Jun;42(3):201-4.
OBJECTIVE
To report experience with the treatment of complications of vinyl glove ingestion in mentally retarded patients with pica.
DESIGN
A retrospective case series.
SETTING
Two university-affiliated hospitals.
PATIENTS
Five mentally retarded patients, 4 with a history of pica, who were admitted for the management of complications resulting from the ingestion of vinyl gloves.
MAIN OUTCOME MEASURES
Type of complication, treatment and operative outcome.
FINDINGS
The patients ranged in age from 26 to 46 years. One patient died while awaiting surgical consultation of massive gastrointestinal bleeding from a large gastric ulcer caused by a vinyl glove bezoar (VGB). Four VGBs were removed surgically. Endoscopic removal was difficult or impossible because the gloves had become hardened and matted.
CONCLUSIONS
VGB should be considered in institutionalized mentally retarded people with a history of pica when they present with gastrointestinal symptoms. VGBs should be removed directly by laparotomy, gastrotomy or enterotomy. Endoscopic removal is not recommended.
目的
报告对患有异食癖的智障患者吞食乙烯基手套并发症的治疗经验。
设计
一项回顾性病例系列研究。
地点
两家大学附属医院。
患者
五名智障患者，其中4名有异食癖病史，因吞食乙烯基手套导致的并发症入院治疗。
主要观察指标
并发症类型、治疗方法及手术结果。
研究结果
患者年龄在26至46岁之间。一名患者在等待因乙烯基手套粪石（VGB）导致的巨大胃溃疡引起的大量胃肠道出血的手术会诊时死亡。通过手术取出了4个VGB。由于手套已变硬并缠结在一起，内镜下取出困难或无法取出。
结论
对于有机构照料且有异食癖病史的智障人士，出现胃肠道症状时应考虑VGB。应通过剖腹术、胃切开术或肠切开术直接取出VGB。不建议内镜下取出。
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