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沙特儿童吞食了什么?一家三级护理中心对吞食异物的 10 年回顾性分析。

What Do Saudi Children Ingest?: A 10-Year Retrospective Analysis of Ingested Foreign Bodies From a Tertiary Care Center.

机构信息

From the Children's Specialized Hospital, King Fahad Medical City.

Department of Biostatistics, Research Services Administration, Research Center, King Fahad Medical City.

出版信息

Pediatr Emerg Care. 2021 Dec 1;37(12):e1044-e1050. doi: 10.1097/PEC.0000000000001894.

Abstract

OBJECTIVES

Few studies investigated the correlation between foreign body (FB) ingestion and occurrence of complications. The local literature is limited to case reports and small case series on esophageal FBs. We conducted this study to identify the high-risk factors predisposing to complications among Saudi children ingesting FBs.

METHODS

The medical records of 436 children (boys, 59.6%; mean age, 4.4 ± 2.7 years) presenting to the emergency department (ED) between 2007 and 2016 were retrospectively reviewed. Relative risk analysis of clinical variables was performed between 2 groups: The first group constituted children without FB-related complications (n = 389), and the second group included those with major complications (n = 14). Major complication was defined as any event associated with significant morbidity such as esophageal stricture, esophageal perforation, esophageal fistula, and intestinal perforation or fistula formation.

RESULTS

Most of the 436 cases presented between ages 2 and 4 years (35.1%). Coin was the most commonly ingested FB (22.9%) followed by button battery (19.5%). Most of the ingested FBs passed spontaneously without intervention (69%). Upper endoscopy was performed in 121 cases (27.7%). By multivariate analysis, the variables that were significantly associated with major complications included the following: very young age group (0-2 years; odds ratio [OR], 11.5), button battery (OR, 4), FB impacted at upper esophagus (OR, 8.7), and longer time duration to visit the ED (OR, 14.7).

CONCLUSION

Button battery impaction at upper esophagus in very young children and delayed presentation to the ED were the most significant risk factors of FB-related complications.

摘要

目的

鲜有研究调查异物(FB)摄入与并发症发生之间的相关性。本地文献仅限于食管 FB 的病例报告和小病例系列。我们进行这项研究旨在确定沙特儿童摄入 FB 导致并发症的高危因素。

方法

回顾性分析 2007 年至 2016 年间在急诊科就诊的 436 名儿童(男孩占 59.6%;平均年龄为 4.4±2.7 岁)的病历。对两组临床变量进行相对风险分析:第一组为无 FB 相关并发症的儿童(n=389),第二组为有严重并发症的儿童(n=14)。严重并发症定义为与显著发病率相关的任何事件,如食管狭窄、食管穿孔、食管瘘和肠穿孔或瘘形成。

结果

436 例病例中,2-4 岁的占 35.1%。最常摄入的 FB 是硬币(22.9%),其次是纽扣电池(19.5%)。大多数摄入的 FB 未经干预即可自行排出(69%)。121 例进行了上消化道内镜检查(27.7%)。多变量分析显示,与严重并发症显著相关的变量包括:非常年幼的年龄组(0-2 岁;比值比[OR],11.5)、纽扣电池(OR,4)、FB 在上食管嵌顿(OR,8.7)和就诊 ED 的时间延长(OR,14.7)。

结论

非常年幼的儿童纽扣电池在上食管嵌顿和就诊 ED 时间延迟是与 FB 相关并发症最显著的危险因素。

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