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上消化道“真性异物”患者的紧急内镜检查——一项1994年至2018年期间的回顾性研究

Urgent endoscopy in patients with "true foreign bodies" in the upper gastrointestinal tract - a retrospective study of the period 1994-2018.

作者信息

Skok Pavel, Skok Kristijan

机构信息

University Medical Center Maribor, Maribor, Slovenia.

University of Maribor, Faculty of Medicine, Maribor, Slovenia.

出版信息

Z Gastroenterol. 2020 Mar;58(3):217-223. doi: 10.1055/a-1062-9011. Epub 2020 Feb 4.

Abstract

AIM

The aim of our study was to determine the frequency of patients with "true foreign bodies" in the upper gastrointestinal tract and to evaluate the success of urgent endoscopic procedures in removing these objects.

MATERIALS AND METHODS

The retrospective study includes patients in which urgent endoscopic investigations of the upper digestive tract were performed in a 23-year period, from 1 January 1994 to 1st January 2018.

RESULTS

Altogether 13 196 patients were investigated: 5147 (39 %) females and 8049 (61 %) males, mean age 62.8 years, SD ± 18.5 years, range 1-106 years. In only 172 patients - 1.3 % of all subjects - true foreign bodies were detected (in range from 1-8) in the esophagus or stomach. In these patients, a total of 242 endoscopic procedures were performed. In 95.9 % the foreign bodies were removed endoscopically (165/172 patients); in 7 cases (4.1 %) the endoscopic procedures were not successful. Among the foreign bodies removed were various metal or plastic objects: hooks, batteries, coins, keys, screws, razor blades, lighters, buttons, toys, 3 toothbrushes as well as impacted safety pins. In patients with successful endoscopic removal, no significant complications were noted. In 12 patients (12/165, 7.2 %), hemorrhages from the region of the esophagogastric junction or stomach were observed; endoscopic hemostasis was performed in 10/12 patients.

CONCLUSIONS

Urgent endoscopy has proved successful in removing true foreign bodies from the upper gastrointestinal tract in the analyzed period. Different factors affect the success of urgent intervention, the most important being adequate experience, skills, and patience of the endoscopic team.

摘要

目的

本研究旨在确定上消化道“真性异物”患者的发生率,并评估急诊内镜下取出这些异物的成功率。

材料与方法

这项回顾性研究纳入了在1994年1月1日至2018年1月1日的23年期间接受上消化道急诊内镜检查的患者。

结果

共对13196例患者进行了检查,其中女性5147例(39%),男性8049例(61%),平均年龄62.8岁,标准差±18.5岁,年龄范围为1 - 106岁。仅在172例患者(占所有受试者的1.3%)的食管或胃中检测到真性异物(数量在1 - 8个之间)。对这些患者共进行了242例内镜操作。95.9%的异物通过内镜取出(165/172例患者);7例(4.1%)内镜操作未成功。取出的异物包括各种金属或塑料制品:钩子、电池、硬币、钥匙、螺丝、剃须刀片、打火机、纽扣、玩具、3把牙刷以及嵌顿的安全别针。在内镜取出成功的患者中,未观察到明显并发症。12例患者(12/165,7.2%)出现食管胃交界处或胃部出血;10/12例患者进行了内镜止血。

结论

在分析的时间段内,急诊内镜已被证明成功地从上消化道取出真性异物。不同因素影响急诊干预的成功率,其中最重要的是内镜团队足够的经验、技能和耐心。

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