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儿童内镜下异物取出术

Endoscopic removal of foreign bodies in children.

作者信息

Lin Chien-Heng, Chen An-Chyi, Tsai Jeng-Dau, Wei Sung-Hsi, Hsueh Kai-Chung, Lin Wei-Ching

机构信息

Department of Pediatrics, Jen-Ai Hospital, Taichung, Taiwan.

出版信息

Kaohsiung J Med Sci. 2007 Sep;23(9):447-52. doi: 10.1016/S1607-551X(08)70052-4.

Abstract

The ingestion of foreign bodies such as coins, fish bones, plastic toy parts, batteries, and needles is common in children. Although the majority of ingested foreign bodies pass through the gastrointestinal tract unaided, some children require either nonsurgical or surgical intervention. The medical records of children who presented to the pediatric emergency department of a single tertiary referral center between December 2001 and May 2006 were reviewed. A total of 87 patients underwent an endoscopic procedure because of suspected foreign body ingestion and foreign bodies were identified by endoscopy in 74 patients (85.1%). The mean age of these 74 patients was 3.4 years (range, 6 months to 13 years). The most common site of foreign body lodgement was the esophagus (n = 38, 51.4%); other sites included the stomach (n = 33, 44.6%) and duodenum (n = 3, 4.0%). The types of foreign bodies included coins (n = 42, 56.8%), button batteries (n = 16, 21.6%), sharp objects (n = 9, 12.2%), chicken bones (n = 2, 2.7%) and others (n = 5, 6.7%). Only two foreign bodies (button batteries) in the duodenum could not be removed successfully by endoscopy. Instead, they were moved into the intestine and then eliminated spontaneously the following day. There were no major complications caused by foreign body ingestion or endoscopic procedures. The outcome of all patients was uneventful without morbidity or mortality. In our experience, endoscopic removal of foreign bodies under general anesthesia is an effective and safe method in children; the method also prevents erosion and perforation of the gastrointestinal tract.

摘要

儿童吞食硬币、鱼骨、塑料玩具部件、电池和针头之类的异物很常见。尽管大多数吞食的异物可自行通过胃肠道,但有些儿童需要非手术或手术干预。回顾了2001年12月至2006年5月期间在一家单一的三级转诊中心儿科急诊科就诊的儿童的病历。共有87例患者因疑似吞食异物接受了内镜检查,74例患者(85.1%)通过内镜检查发现了异物。这74例患者的平均年龄为3.4岁(范围为6个月至13岁)。异物最常见的嵌顿部位是食管(n = 38,51.4%);其他部位包括胃(n = 33,44.6%)和十二指肠(n = 3,4.0%)。异物类型包括硬币(n = 42,56.8%)、纽扣电池(n = 16,21.6%)、尖锐物体(n = 9,12.2%)、鸡骨头(n = 2,2.7%)和其他(n = 5,6.7%)。十二指肠内的两枚异物(纽扣电池)无法通过内镜成功取出。相反,它们被移入肠道,第二天自行排出。吞食异物或内镜检查未引起重大并发症。所有患者的结局均平稳,无 morbidity 或 mortality。根据我们的经验,全身麻醉下内镜取出异物对儿童来说是一种有效且安全的方法;该方法还可防止胃肠道的糜烂和穿孔。

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