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回顾性分析中国单中心收治的儿童吞食多种稀土磁体病例。

Retrospective analysis of pediatric patients with multiple rare-earth magnets ingestion: a single-center experience from China.

机构信息

Department of Gastroenterology, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China.

出版信息

BMC Pediatr. 2021 Apr 17;21(1):179. doi: 10.1186/s12887-021-02642-y.

Abstract

BACKGROUND

The aim of this study was to characterize patients who ingested multiple rare-earth magnets, reveal the harm of rare-earth magnet foreign bodies in the digestive tract, and develop a clinical management algorithm.

METHODS

This was a retrospective review of patients with rare-earth magnet foreign bodies in the digestive tract admitted to a university-affiliated pediatric medical center in China, between January 2016 and December 2019; the subset of medical data evaluated included clinical symptoms, signs, treatments and outcomes.

RESULTS

A total of 51 cases were included in this study, including 36(70.6%) males and 15(29.4%) females. The magnets were passed naturally in 24(47.1%) patients and removed by intervention in 27(52.9%) patients, including 5(9.8%) cases by endoscopy and 22(43.1%) cases by surgery. Twenty-two (43.1%)cases had gastrointestinal obstruction, perforation, and fistula. Compared with the non-surgical group, the time of the surgical group from ingestion to arriving at the hospital was longer([80(5-336) vs 26(2-216)]hours, p < 0.001) while there was no significant difference in the mean age or the number of magnets swallowed.

CONCLUSIONS

Magnets are attractive to children, but lead to catastrophic consequences including gastrointestinal obstruction, perforation, and surgical interventions when ingested multiple magnets. Endoscopic resection should be urgently performed in the presence of multiple magnets as early as possible within 24 h, even in asymptomatic patients.

摘要

背景

本研究旨在对吞食多个稀土磁体的患者进行临床特征分析,揭示稀土磁体异物在消化道中的危害,并制定临床管理方案。

方法

这是一项对 2016 年 1 月至 2019 年 12 月期间在中国一家大学附属医院就诊的消化道内稀土磁体异物患者的回顾性研究,评估的部分医疗数据包括临床症状、体征、治疗和结局。

结果

本研究共纳入 51 例患者,其中男 36 例(70.6%),女 15 例(29.4%)。24 例(47.1%)患者的磁体自然排出,27 例(52.9%)患者通过干预取出,其中 5 例(9.8%)经内镜取出,22 例(43.1%)经手术取出。22 例(43.1%)患者出现胃肠道梗阻、穿孔和瘘管。与非手术组相比,手术组从吞食到到达医院的时间更长[(80(5-336)比 26(2-216)]小时,p<0.001],而两组的平均年龄或吞食的磁体数量无显著差异。

结论

磁铁对儿童具有吸引力,但吞食多个磁铁会导致严重后果,包括胃肠道梗阻、穿孔和外科干预。当存在多个磁铁时,应尽早在 24 小时内进行内镜切除,即使无症状患者也应如此。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0424/8052718/13cd294d79da/12887_2021_2642_Fig1_HTML.jpg

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