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成人枣核致食管异物嵌顿并发症的管理与危险因素分析

Analysis of the management and risk factors for complications of esophageal foreign body impaction of jujube pits in adults.

作者信息

Zhang Xiaowen, Zhang Xiaoheng, Tu Chunmei, Yu Qianqian, Fu Tao

机构信息

Department of Otorhinolaryngology, The Affiliated Hospital of Qingdao University, Qingdao, China.

Department of Otorhinolaryngology, First People's Hospital of Jinan, Jinan, China.

出版信息

Wideochir Inne Tech Maloinwazyjne. 2018 Jun;13(2):250-256. doi: 10.5114/wiitm.2018.73132. Epub 2018 Feb 2.

Abstract

INTRODUCTION

Foreign body impaction is a common emergency in the field of otolaryngology. The prevalence of a jujube pit as an esophageal foreign body has increased in the Jiaodong Peninsula. However, reports on this are scarce.

AIM

To investigate the methods for diagnosing and treating esophageal foreign body impaction of a jujube pit and to determine the risk factors for complications.

MATERIAL AND METHODS

We conducted a retrospective review of the medical records of patients who were diagnosed with esophageal impaction of a jujube pit. Demographic, clinical, radiological, and endoscopic data were collected and analyzed.

RESULTS

Neither plain radiography nor esophagogram provided enough information on the surrounding issues and complications. The rate of secondary radiological examination was 51.61% for the patients who did not undergo prior computed tomography. The success rate of rigid esophagoscopy was 95.45%; 18 of these patients (27.27%) had previously undergone flexible esophagoscopy without foreign body removal. Logistic regression showed that the time from ingestion to presentation and the jujube pit size were independent risk factors for complications.

CONCLUSIONS

Computed tomography without contrast material is the preferred diagnostic method for adults with esophageal jujube pit impaction, and rigid esophagoscopy can be used for therapy even though the first flexible esophagoscopy failed. Large diameter of the jujube pit constituting the esophageal foreign body (≥ 25 mm) and long duration between pit ingestion and presentation (> 12 h) were associated with increased complications in the patients in this study.

摘要

引言

异物嵌顿是耳鼻咽喉科常见的急症。在胶东半岛,枣核作为食管异物的发生率有所上升。然而,关于这方面的报道却很少。

目的

探讨枣核所致食管异物嵌顿的诊断和治疗方法,并确定并发症的危险因素。

材料与方法

我们对诊断为枣核食管嵌顿的患者病历进行了回顾性研究。收集并分析了人口统计学、临床、放射学和内镜检查数据。

结果

普通X线摄影和食管造影均未提供足够的周围组织及并发症信息。未进行过计算机断层扫描的患者二次放射学检查率为51.61%。硬质食管镜检查成功率为95.45%;其中18例患者(27.27%)此前曾接受过柔性食管镜检查但未取出异物。Logistic回归分析显示,从吞入到就诊的时间和枣核大小是并发症的独立危险因素。

结论

对于成人枣核食管嵌顿,无对比剂的计算机断层扫描是首选的诊断方法,即使首次柔性食管镜检查失败,硬质食管镜检查仍可用于治疗。本研究中,构成食管异物的枣核直径较大(≥25mm)以及从吞入枣核到就诊的时间较长(>12小时)与患者并发症增加有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4359/6041575/d84adb1f128c/WIITM-13-31624-g001.jpg

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