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儿童食管异物的球囊取出术

Balloon extraction of esophageal foreign bodies in children.

作者信息

Morrow S E, Bickler S W, Kennedy A P, Snyder C L, Sharp R J, Ashcraft K W

机构信息

The Children's Mercy Hospital, Kansas City, MO 64108-4698, USA.

出版信息

J Pediatr Surg. 1998 Feb;33(2):266-70. doi: 10.1016/s0022-3468(98)90444-4.

Abstract

BACKGROUND

Whereas esophageal foreign bodies are commonly removed with rigid esophagoscopy under general anesthesia, selected foreign bodies also can be removed using a Foley catheter balloon under fluoroscopic control without anesthesia. The authors prefer to initially attempt removal of smooth, radiopaque esophageal foreign bodies using the balloon technique and then proceed to rigid esophagoscopy if unsuccessful.

METHODS

The authors reviewed their 7-year experience with this approach in 276 children with esophageal foreign bodies.

RESULTS

One hundred seventy-three children underwent attempted balloon extraction, and 146 of these underwent successful removal with this method. Fifteen remained lodged in the esophagus and were subsequently removed by esophagoscopy, and 12 passed into the stomach and were observed. The only complication was one episode of epistaxis that resolved. Success of the balloon method was not related to patient age, foreign body duration, location, or presenting symptoms. The use of more than 5 minutes of fluoroscopy time was associated with a low likelihood of successful extraction.

CONCLUSION

The balloon extraction technique is a safe and effective alternative to rigid esophagoscopy for the removal of selected esophageal foreign bodies in children.

摘要

背景

虽然食管异物通常在全身麻醉下通过硬式食管镜取出,但某些异物也可在透视引导下使用 Foley 导管球囊在无麻醉的情况下取出。作者更倾向于首先尝试使用球囊技术取出光滑、不透 X 线的食管异物,若不成功则进行硬式食管镜检查。

方法

作者回顾了他们在 7 年里对 276 例食管异物患儿采用这种方法的经验。

结果

173 例患儿尝试进行球囊取出,其中 146 例通过该方法成功取出。15 例仍滞留在食管,随后通过食管镜取出,12 例进入胃内并进行观察。唯一的并发症是 1 次鼻出血,已缓解。球囊法的成功与患儿年龄、异物存留时间、位置或就诊症状无关。透视时间超过 5 分钟与成功取出的可能性较低相关。

结论

对于取出儿童特定的食管异物,球囊取出技术是硬式食管镜检查的一种安全有效的替代方法。

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