Orthopedics Department, Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Yuzhong District Zhongshan 2road 136#, Chongqing, 400014, People's Republic of China.
Ministry of Education Key Laboratory of Child Development and Disorders, Children's Hospital of Chongqing Medical University, Yuzhong District Zhongshan 2road 136#, Chongqing, 400014, People's Republic of China.
Int Orthop. 2022 Aug;46(8):1831-1838. doi: 10.1007/s00264-022-05427-9. Epub 2022 May 10.
Soft tissue foreign bodies (FBs) are very commonly observed in paediatric emergency departments. Not all FBs can be removed effectively, even via open surgery and image intensifier guidance. In the current study, we evaluated the efficiency of FB removal with the assistance of ultrasound (US) and methylene blue (MB) staining.
We enrolled 80 patients at our clinical center between May 2016 and December 2020. Eleven patients were operated upon with the assistance of US guidance and MB and were defined as group A; the other 69 patients were defined as group B. For the patients in group A, US was first used to locate the FB; MB was then injected next to the FB. Open surgery was subsequently performed. For group B, the FBs were removed by conventional methods. The surgical outcomes were evaluated according to surgical duration, incision infection rates, radiograph exposure times, and FB residue rates.
The average surgery time for group A was 0.35 ± 0.10 hours; the corresponding time was 0.49 ± 0.50 hours in group B and there was a significant difference between the groups (p = 0.032). The radiograph exposure times were 1.33 ± 0.34 in group A and 4.65 ± 1.81 times in group B (p = 0.021).
This study demonstrates that assistance of US and MB staining is a more efficient approach compared with traditional methods for FB removal, and this surgical method can be used effectively for FB removal in children.
软组织异物(FB)在儿科急诊中非常常见。并非所有 FB 都能有效去除,即使采用开放手术和影像增强器引导。在本研究中,我们评估了超声(US)和亚甲蓝(MB)染色辅助下 FB 去除的效率。
我们于 2016 年 5 月至 2020 年 12 月在我们的临床中心招募了 80 名患者。11 名患者在 US 引导和 MB 辅助下进行手术,定义为 A 组;其余 69 名患者定义为 B 组。对于 A 组患者,首先使用 US 定位 FB;然后将 MB 注射到 FB 旁边。随后进行开放手术。对于 B 组,采用常规方法去除 FB。根据手术时间、切口感染率、X 线曝光时间和 FB 残留率评估手术结果。
A 组的平均手术时间为 0.35±0.10 小时;B 组的相应时间为 0.49±0.50 小时,两组间有显著差异(p=0.032)。A 组的 X 线曝光时间为 1.33±0.34 次,B 组为 4.65±1.81 次(p=0.021)。
本研究表明,与传统方法相比,US 和 MB 染色辅助是一种更有效的 FB 去除方法,这种手术方法可有效用于儿童 FB 去除。