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小儿磁铁吞食:原力的黑暗面。

Pediatric magnet ingestions: the dark side of the force.

机构信息

Division of Pediatric Emergency Medicine, Seattle Children's Hospital, Seattle, WA, USA.

Department of Radiology, University of Washington, Seattle, WA, USA.

出版信息

Am J Surg. 2014 May;207(5):754-9; discussion 759. doi: 10.1016/j.amjsurg.2013.12.028. Epub 2014 Mar 11.

Abstract

BACKGROUND

Pediatric magnet ingestions are increasing. Commercial availability of rare-earth magnets poses a serious health risk. This study defines incidence, characteristics, and management of ingestions over time.

METHODS

Cases were identified by searching radiology reports from June 2002 to December 2012 at a children's hospital and verified by chart and imaging review. Relative risk (RR) regressions determined changes in incidence and interventions over time.

RESULTS

In all, 98% of ingestions occurred since 2006; 57% involved multiple magnets. Median age was 8 years (range 0 to 18); 0% of single and 56% of multiple ingestions required intervention. Compared with 2007 to 2009, ingestions increased from 2010 to 2012 (RR = 1.9, 95% confidence interval 1.2 to 3.0). Intervention proportion was unchanged (RR = .94, 95% confidence interval .4 to 2.2). Small spherical magnets comprised 26.8% of ingestions since 2010; 86% involved multiple magnets and 47% required intervention.

CONCLUSIONS

Pediatric magnet ingestions and interventions have increased. Multiple ingestions prompt more imaging and surgical interventions. Magnet safety standards are needed to decrease risk to children.

摘要

背景

儿科磁铁摄入的情况正在增加。商业上可获得的稀土磁铁对健康构成严重威胁。本研究旨在确定随时间推移的摄入病例的发生率、特征和处理方法。

方法

通过搜索一家儿童医院 2002 年 6 月至 2012 年 12 月的放射学报告,确定病例,并通过图表和影像学回顾进行验证。相对风险(RR)回归确定随时间推移发生率和干预措施的变化。

结果

所有摄入病例均发生在 2006 年以后;57%涉及多个磁铁。中位年龄为 8 岁(范围 0 至 18 岁);0%的单个磁铁摄入和 56%的多个磁铁摄入需要干预。与 2007 年至 2009 年相比,2010 年至 2012 年的摄入病例有所增加(RR=1.9,95%置信区间 1.2 至 3.0)。干预比例保持不变(RR=0.94,95%置信区间 0.4 至 2.2)。自 2010 年以来,小的球形磁铁占摄入病例的 26.8%;86%涉及多个磁铁,47%需要干预。

结论

儿科磁铁摄入和干预有所增加。多个磁铁摄入需要更多的影像学和手术干预。需要制定磁铁安全标准以降低儿童的风险。

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