Division of Pediatric Emergency Medicine, Seattle Children's Hospital, Seattle, WA, USA.
Department of Radiology, University of Washington, Seattle, WA, USA.
Am J Surg. 2014 May;207(5):754-9; discussion 759. doi: 10.1016/j.amjsurg.2013.12.028. Epub 2014 Mar 11.
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.
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.
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.
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.
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。
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。
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。
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。
