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用于清除上消化道异物的内镜手术:布甘多医疗中心的经验。

Endoscopic procedures for removal of foreign bodies of the aerodigestive tract: The Bugando Medical Centre experience.

作者信息

Gilyoma Japhet M, Chalya Phillipo L

机构信息

Department of Surgery, Weill- Bugando University College of Health Sciences, Mwanza, Tanzania.

出版信息

BMC Ear Nose Throat Disord. 2011 Jan 21;11:2. doi: 10.1186/1472-6815-11-2.

Abstract

BACKGROUND

Foreign bodies in the aerodigestive tract continue to be a common problem that contributes significantly to high morbidity and mortality worldwide. This study was conducted to describe our own experience with endoscopic procedures for removal of foreign bodies in the aerodigestive tract, in our local setting and compare with what is described in literature.

METHODS

This was a prospective descriptive study which was conducted at Bugando Medical Centre between January 2008 and December 2009. Data were collected using a structured questionnaire and analyzed using SPSS computer software version 15.

RESULTS

A total of 98 patients were studied. Males outnumbered females by a ratio of 1.1:1. Patients aged 2 years and below were the majority (75.9%). The commonest type of foreign bodies in airways was groundnuts (72.7%) and in esophagus was coins (72.7%). The trachea (52.2%) was the most common site of foreign body's lodgment in the airways, whereas cricopharyngeal sphincter (68.5%) was the commonest site in the esophagus. Rigid endoscopy with forceps removal under general anesthesia was the main treatment modality performed in 87.8% of patients. The foreign bodies were successfully removed without complications in 90.8% of cases. Complication rate was 7.1% and bronchopneumonia was the most common complication accounting for 42.8% of cases. The mean duration of hospital stay was 3.4 days and mortality rate was 4.1%.

CONCLUSION

Aerodigestive tract foreign bodies continue to be a significant cause of childhood morbidity and mortality in our setting. Rigid endoscopic procedures under general anesthesia are the main treatment modalities performed. Prevention is highly recommended whereby parents should be educated to keep a close eye on their children and keep objects which can be foreign bodies away from children's reach.

摘要

背景

气道消化道异物仍是一个常见问题,在全球范围内导致了较高的发病率和死亡率。本研究旨在描述我们在当地环境中通过内镜手术取出气道消化道异物的经验,并与文献中描述的情况进行比较。

方法

这是一项前瞻性描述性研究,于2008年1月至2009年12月在布甘多医疗中心进行。使用结构化问卷收集数据,并使用SPSS计算机软件版本15进行分析。

结果

共研究了98例患者。男性与女性的比例为1.1:1,男性多于女性。2岁及以下的患者占大多数(75.9%)。气道中最常见的异物类型是花生(72.7%),食管中是硬币(72.7%)。气管(52.2%)是气道中异物最常见的滞留部位,而环咽括约肌(68.5%)是食管中最常见的部位。87.8%的患者主要治疗方式是在全身麻醉下通过硬式内镜用钳子取出异物。90.8%的病例异物成功取出且无并发症。并发症发生率为7.1%,支气管肺炎是最常见的并发症,占病例的42.8%。平均住院时间为3.4天,死亡率为4.1%。

结论

在我们的环境中,气道消化道异物仍然是儿童发病和死亡的重要原因。全身麻醉下的硬式内镜手术是主要的治疗方式。强烈建议进行预防,应教育家长密切关注孩子,并将可能成为异物的物品放在孩子够不到的地方。

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