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[儿科急诊科消化道异物摄入的会诊情况。]

[Consultations for digestive foreign bodies ingestion in a pediatric emergency department.].

作者信息

Martí-Castellote Celia, López-González Aitor, Trenchs Sainz de la Maza Victoria, Curcoy Barcenilla Ana, Alsina Rossell Judit, Luaces Cubells Carles

机构信息

Servicio de Urgencias de Pediatría. Hospital Sant Joan de Déu. Esplugues de Llobregat. Barcelona. España.

Universitat de Barcelona. Barcelona. España.

出版信息

Rev Esp Salud Publica. 2020 Jul 30;94:e202007076.

Abstract

OBJECTIVE

Foreign body (FB) ingestion distresses many families who consult the emergency department promptly. The objective of the study is to determine the epidemiological characteristics of children who consult due to suspected FB intake and its consequences.

METHODS

Descriptive-observational study, carried out in a third-level maternal and child center. Emergency reports were selected from patients under 18 years of age with a diagnosis of discharge "Ingesta CE" (code 938 CIM-9-MC until May 2018; code T18.9XXA CIM-10-MC later) from 1/1/2017 until 12/31/2018. Miscoded and reconsultations within the same episode were excluded. Data was analysed with the statistics program SPSS 25.0.

RESULTS

458 cases were included; median age 3.8 years (p25-75: 1.9-6.6 years); 267 (58.3%) males. 78.9% consulted in the first 6 hours after intake. Accidental cause was reported in 98.9% of cases. In 96.7% a single FB was ingested. The most frequent types of object were metallic (46.7%), plastics (16.4%) and food bones/shells (12.9%). The 23.6% of FB involved were sharp/pointed. 49.1% of the patients presented symptoms. A complementary test was performed in 69.4%, especially radiographs (63.5%). Metal detector was used in 10%. 9.6% required endoscopy. 90.4% were discharged from the emergency department, with 12.1% of reconsultations.

CONCLUSIONS

Consultations for FB ingestion are relatively frequent in the emergency department and, although most of them are discharged, many patients require complementary tests and a non-negligible number, endoscopy. The patient's profile is that of a preschooler who spontaneously goes to the emergency room due to an accidental ingestion of a blunt metallic object.

摘要

目的

异物(FB)摄入使许多家庭苦恼,他们会迅速前往急诊科就诊。本研究的目的是确定因疑似FB摄入而就诊的儿童的流行病学特征及其后果。

方法

在一家三级妇幼中心开展描述性观察研究。选取2017年1月1日至2018年12月31日期间18岁以下诊断为出院“Ingesta CE”(2018年5月前为国际疾病分类第9版(ICD-9)代码938 CIM-9-MC;之后为国际疾病分类第10版(ICD-10)代码T18.9XXA CIM-10-MC)的患者的急诊报告。排除同一病程中编码错误和再次就诊的情况。使用统计软件SPSS 25.0进行数据分析。

结果

纳入458例病例;中位年龄3.8岁(第25-75百分位数:1.9-6.6岁);男性267例(58.3%)。78.9%在摄入后6小时内就诊。98.9%的病例报告为意外原因。96.7%摄入单个FB。最常见的异物类型为金属(46.7%)、塑料(16.4%)和食物骨头/贝壳(12.9%)。23.6%的FB有尖锐/尖状部分。49.1%的患者出现症状。69.4%的患者进行了辅助检查,尤其是X线片(63.5%)。10%使用了金属探测器。9.6%需要进行内镜检查。90.4%从急诊科出院,其中12.1%再次就诊。

结论

急诊科因FB摄入就诊相对频繁,尽管大多数患者出院,但许多患者需要辅助检查,且有不可忽视数量的患者需要内镜检查。患者的特征是学龄前儿童,因意外摄入钝性金属物体而自发前往急诊室。

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本文引用的文献

1
Foreign Bodies in the Abdominal Area: Review of the Literature.腹部区域的异物:文献综述
Acta Medica (Hradec Kralove). 2019;62(3):85-93. doi: 10.14712/18059694.2019.130.
4
Predictors of nature of ingested foreign bodies in children & assessment of operative outcomes.儿童摄入异物性质的预测因素及手术结果评估
Int J Pediatr Otorhinolaryngol. 2018 Oct;113:150-155. doi: 10.1016/j.ijporl.2018.07.032. Epub 2018 Jul 24.
6
Foreign Body Ingestion in Children.儿童异物摄入
Clin Endosc. 2018 Mar;51(2):129-136. doi: 10.5946/ce.2018.039. Epub 2018 Mar 30.

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