Waters Alicia M, Teitelbaum Daniel H, Thorne Vivian, Bousvaros Athos, Noel R Adam, Beierle Elizabeth A
Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama.
Department of Surgery, University of Michigan, Ann Arbor, Michigan.
J Surg Res. 2015 Nov;199(1):137-40. doi: 10.1016/j.jss.2015.04.007. Epub 2015 Apr 8.
Foreign body ingestion remains a common reason for emergency room visits and operative interventions in the pediatric population. Rare earth magnet ingestion represents a low percentage of all foreign bodies swallowed by children; however, magnets swallowed in multiplicity can result in severe injuries.
Pediatric surgeons with membership in the Surgical Section of the American Academy of Pediatrics were surveyed to determine the magnitude and consequences of magnet ingestions in the pediatric population.
About 100 (16%) participant responses reported on 99 magnet ingestions. The median age at ingestion was 3.7 y, and the majority of ingestions (71%) occurred after year 2010. Thirty-two children underwent endoscopy with successful removal in 70% of cases, and multiple magnets were found in 65% of these patients. Seventy-three children required either laparotomy (51) or laparoscopy (22) for magnet removal, and 90% of these children were discovered to have ingested more than one magnet. In addition, 17% of the children were found to have at least one perforation or fistula, and 34% of the children had multiple perforations or fistulae. Nine children required long-term care for their injuries including repeat endoscopies. One child died after hemorrhage from an esophago-aortic fistula.
These results demonstrated the increasing need for magnet regulations and public awareness to prevent potentially serious complications.
异物摄入仍是儿科患者前往急诊室就诊和接受手术干预的常见原因。稀土磁铁摄入在儿童吞食的所有异物中占比很低；然而，吞食多个磁铁可能会导致严重伤害。
对美国儿科学会外科分会的儿科外科医生进行了调查，以确定儿科患者中磁铁摄入的规模和后果。
约100名（16%）参与者报告了99例磁铁摄入情况。摄入时的中位年龄为3.7岁，大多数摄入情况（71%）发生在2010年之后。32名儿童接受了内镜检查，70%的病例成功取出异物，其中65%的患者发现有多个磁铁。73名儿童需要进行剖腹手术（51例）或腹腔镜手术（22例）以取出磁铁，这些儿童中有90%被发现吞食了不止一个磁铁。此外，17%的儿童被发现至少有一处穿孔或瘘管，34%的儿童有多处穿孔或瘘管。9名儿童因伤需要长期护理，包括重复进行内镜检查。一名儿童因食管主动脉瘘出血死亡。
这些结果表明，越来越需要对磁铁进行监管并提高公众意识，以预防潜在的严重并发症。
