Jia Wenyuan, Xu Guanghui, Xie Jiangang, Zhen Luming, Chen Mengsha, He Chuangye, Yuan Xulong, Yu Chaoping, Fang Ying, Tie Jun, Wei Haidong
Digestive Diseases of Xijing Hospital, Fourth Military Medical University, Xi'an, China.
Department of Emergency, Xijing Hospital, Fourth Military Medical University, Xi'an, China.
Front Pediatr. 2022 May 12;10:804669. doi: 10.3389/fped.2022.804669. eCollection 2022.
Accidental ingestion of button batteries (BB), usually occurred in children and infants, will rapidly erode the esophagus and result in severe complications, even death. It has been recommended that treatment of this emergent accident as soon as possible with drinking of pH-neutralizing viscous solutions such as honey and sucralfate before surgical removal can mitigate the esophageal injury. Recently, we reported that the electric insulating solutions such as edible oils could mitigate tissue damage in BB-exposed esophageal segments. In this study, we compared the protective effect of kitchen oil with honey or sucralfate, the recommended pH-neutralizing beverages, and with their mixture on esophageal injury caused by BB ingestion in pig esophageal segments and in living piglets.
Effect of olive oil irrigations was compared to that of honey or sucralfate irrigations in the BB-damaged esophageal segments freshly collected from the local abattoir and in live Bama miniature piglets with the proximal esophagus exposed to BB for 60 min. Also, the effect of olive oil and honey mixture (MOH) irrigations was assessed in live animals. The BB voltage was recorded before insertion and after its removal. Gross and histological analysis of the esophageal injury was performed after BB exposure in segmented fresh esophagus and 7 days after BB exposure in live animals, respectively.
Olive oil irrigations demonstrated better protective effect against BB-induced esophageal damage, compared to honey or sucralfate for BB-induced esophageal damage . But study showed that olive oil alone exacerbated esophageal injury because all esophagi irrigated with olive oil perforated. Surprisingly, irrigations with the MOH showed considerable protective effect for BB-induced esophageal damage in live animals, significantly better than irrigations with honey alone. The MOH decreased BB discharge, reduced area of surface injury, attenuated injured depth of esophageal wall thickness, and downed the mucosal injury index in comparison to using honey alone.
Irrigations with olive oil alone couldn't prevent the BB discharge and is harmful for BB ingestion before surgical removal. However, mixed with honey, olive oil very effectively prevents the BB discharging and produces better esophageal protection than honey.
纽扣电池（BB）意外摄入通常发生于儿童和婴儿，会迅速腐蚀食管并导致严重并发症甚至死亡。建议在手术取出前尽快用饮用蜂蜜和硫糖铝等pH中和粘性溶液来治疗这种紧急事故，以减轻食管损伤。最近，我们报道食用油等电绝缘溶液可减轻暴露于BB的食管段的组织损伤。在本研究中，我们比较了食用油与蜂蜜或硫糖铝（推荐的pH中和饮料）及其混合物对猪食管段和活体仔猪因摄入BB所致食管损伤的保护作用。
将从当地屠宰场新鲜采集的暴露于BB的食管段以及近端食管暴露于BB 60分钟的活体巴马小型仔猪中，比较橄榄油冲洗与蜂蜜或硫糖铝冲洗的效果。此外，还评估了橄榄油和蜂蜜混合物（MOH）冲洗在活体动物中的效果。在插入BB前和取出后记录其电压。分别在分段新鲜食管暴露于BB后以及活体动物暴露于BB 7天后，对食管损伤进行大体和组织学分析。
与蜂蜜或硫糖铝相比，橄榄油冲洗对BB诱导的食管损伤显示出更好的保护作用。但研究表明，单独使用橄榄油会加重食管损伤，因为所有用橄榄油冲洗的食管均发生穿孔。令人惊讶的是，MOH冲洗对活体动物中BB诱导的食管损伤显示出相当大的保护作用，明显优于单独用蜂蜜冲洗。与单独使用蜂蜜相比，MOH减少了BB放电，减少了表面损伤面积，减轻了食管壁厚度的损伤深度，并降低了黏膜损伤指数。
单独用橄榄油冲洗不能防止BB放电，且在手术取出前对摄入BB有害。然而，与蜂蜜混合后，橄榄油能非常有效地防止BB放电，并比蜂蜜产生更好的食管保护作用。
