Shao Fangbin, Shen Nannan, Hong Zipu, Chen Xiaoming, Lin Xiaokun
Department of Pediatric Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.
Department of Pediatric Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
J Paediatr Child Health. 2020 Apr;56(4):537-541. doi: 10.1111/jpc.14677. Epub 2019 Nov 6.
Foreign body (FB) injuries represent a severe public health problem during childhood. The aim of this study was to report our experience with patients with injuries due to FB ingestion and insertion who were treated surgically at our institution.
A total of 78 paediatric patients who were hospitalised for FB injuries were retrospectively reviewed.
The series was composed of 27 males and 51 females, with a median age of 3.6 years. The cases included 35 cases of FB ingestion and 43 cases of FB insertion, including 40 cases with a vaginal insertion, 2 cases with a rectal insertion and 1 case with a urethra insertion. Intestinal perforation (n = 26) was a more common complication than intestinal obstruction (n = 9) in patients who had ingested a FB. The main clinical symptom was persistent vaginal discharge, followed by vaginal bleeding for patients with a vaginal FB insertion. Exploratory laparotomy was performed on 36 patients, while a laparoscopic approach was employed in 1 patient. Forty patients underwent hysteroscopy and one patient underwent cystotomy to remove the FB. All FBs were successfully removed. Of the 78 FBs recovered, 26 were food objects, while non-food objects were found in 52 patients. All patients recovered well, except one patient with an intestinal obstruction from adhesions that occurred approximately 1 month after discharge.
Early recognition of FB injuries and appropriate management can significantly reduce complications. Surgical removal of a FB can be safe and effective, and relatively better outcomes can be achieved.
异物（FB）损伤是儿童时期严重的公共卫生问题。本研究的目的是报告我们机构对因吞食和插入异物而受伤并接受手术治疗的患者的治疗经验。
对78例因异物损伤住院的儿科患者进行回顾性分析。
该系列包括27例男性和51例女性，中位年龄为3.6岁。病例包括35例异物吞食和43例异物插入，其中40例为阴道插入，2例为直肠插入，1例为尿道插入。在吞食异物的患者中，肠穿孔（n = 26）比肠梗阻（n = 9）更常见。主要临床症状是持续性阴道分泌物，其次是阴道异物插入患者的阴道出血。36例患者进行了剖腹探查术，1例采用了腹腔镜手术。40例患者接受了宫腔镜检查，1例患者接受了膀胱切开术以取出异物。所有异物均成功取出。在回收的78个异物中，26个是食物，52例患者发现的是非食物异物。除1例出院后约1个月因粘连导致肠梗阻的患者外，所有患者恢复良好。
早期识别异物损伤并进行适当处理可显著减少并发症。手术取出异物安全有效，可取得相对较好的效果。
