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磁体异物损伤:一家大型儿童医院的经验。

Magnetic foreign body injuries: a large pediatric hospital experience.

机构信息

Hospital for Sick Children, Toronto, Ontario, Canada; Division of General Surgery, University of Toronto, Toronto, Ontario, Canada.

Hospital for Sick Children, Toronto, Ontario, Canada; Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada.

出版信息

J Pediatr. 2014 Aug;165(2):332-5. doi: 10.1016/j.jpeds.2014.04.002. Epub 2014 May 16.

Abstract

OBJECTIVE

To examine trends in magnet-related injuries and hypothesize that changes are a result of new neodymium-iron-boron magnets that are smaller, stronger, and commonly sold in sets.

STUDY DESIGN

In this retrospective chart review, we searched our institution's electronic patient record for patients less than 18 years old who were diagnosed with magnetic foreign body ingestion between 2002 and 2012. Cases were analyzed for patient, magnetic foreign body, and management characteristics. Incidence rates and case characteristics were compared between the first 8 years of the study period and the last 3.

RESULTS

We identified 94 patients who met our search criteria. Of confirmed ingestions, the median age was 4.5 years and 65% were male. The incidence of visits increased between the 2002-2009 period and the 2010-2012 period by a factor of 2.94 (95% CI, 1.84-4.70), whereas the incidence of injuries involving multiple magnets increased by a factor of 8.40 (95% CI, 3.44-20.56). The volume of the magnets decreased from 878.6 mm3 to 259.8 mm3. Six cases required surgical removal of the magnets because of intra-abdominal sepsis or concern for imminent bowel perforation.

CONCLUSIONS

Since 2002, there has been a significant increase in the incidence of magnetic foreign body injuries. These injuries have increasingly involved multiple, smaller magnets and required operative intervention.

摘要

目的

研究与磁铁相关的伤害趋势,并假设这些变化是由于新型钕铁硼磁铁所致,这些磁铁体积更小、磁性更强,且通常成套销售。

研究设计

在这项回顾性图表研究中,我们检索了本机构电子病历中 2002 年至 2012 年间年龄小于 18 岁、被诊断为磁性异物吞食的患者。对患者、磁性异物和管理特征进行了分析。比较了研究前 8 年和后 3 年的发生率和病例特征。

结果

我们共确定了 94 名符合检索标准的患者。经证实的吞食病例中,中位年龄为 4.5 岁,65%为男性。2002-2009 年期间就诊人数是 2010-2012 年期间的 2.94 倍(95%CI,1.84-4.70),而涉及多个磁铁的伤害发生率增加了 8.40 倍(95%CI,3.44-20.56)。磁铁体积从 878.6mm3 减小到 259.8mm3。6 例因腹腔感染或担心即将发生肠穿孔而需要手术切除磁铁。

结论

自 2002 年以来,磁性异物伤害的发生率显著增加。这些伤害越来越多地涉及多个较小的磁铁,并需要手术干预。

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