[1]王丽,李学佩,闫燕,等.复杂食管异物的诊治(附64例报告)[J].中国微创外科杂志,2005,05(3):233-235.
　Wang Li,LiXuepei,Yan Yan,et al.Complicated esophageal foreign bodies: Diagnosis and treatment in 64 cases[J].Chinese Journal of Minimally Invasive Surgery,2005,05(3):233-235.
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复杂食管异物的诊治(附64例报告)()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
05
期数:
2005年3期
页码:
233-235
栏目:
出版日期:
2005-03-31

文章信息/Info

Title:
Complicated esophageal foreign bodies: Diagnosis and treatment in 64 cases
作者:
王丽; 李学佩; 闫燕; 潘滔; 周玉英; 宋为明　
北京大学第三医院耳鼻咽喉科,北京,100083
Author(s):
Wang Li;  LiXuepei;  Yan Yan;  et al.
Department of Otorhinolaryngology, Peking University Third Hospital, Beijing 100083, China
关键词:
食管异物;  食管镜;  食管穿孔
Keywords:
Esophageal foreign body; 　Esophagoscope; 　Esophageal perforatio
分类号:
R768.4
文献标志码:
A
摘要:
目的总结复杂食管异物的诊治经验. 方法回顾性分析我院1994年1月～2004年7月64例复杂食管异物的临床资料,分析异物种类和停留部位. 结果动物骨类异物占50.0%(32/64),义齿占20.3%(13/64),枣核占14.1%(9/64),其它异物占15.6%(10/64).异物停留在第一、二、三狭窄区分别占68.7%(44/64)、26.6%(17/64)、1.6%(1/64),2例(2/64,3.1%)停留在食管癌术后吻合口上方.与50岁以下患者相比,50岁以上患者义齿类异物及第二狭窄区异物比例增高,分别为30.0%(9/30)与43.3%(13/30),差异有显著性(P<0.05);59例经内镜取出异物治愈,3例颈侧切开治愈,2例转院治疗.食管穿孔6例,4例由食管异物本身造成,2例取异物时手术所致;5例异物取出经保守治愈,1例异物未取出转院治疗. 结论详细询问病史,了解异物种类、停留部位和对周围组织损伤的程度,选择适当麻醉、内镜与操作手法,对安全取出异物以及预防并发症极为重要.
Abstract:
Objective　To summarize the experience in the diagnosis and management of complicated esophageal foreign bodies.　M ethods　A retrospective studywas conducted in 64 patientswith complicated esophageal foreign bodies from January 1994 to July2004 in this hospita.l Types and location of foreign bodies ingestedwere analyzed.　Results　Animalbones accounted for50% of foreign bodies ingested (32/64) and foreign bodies located at the esophageal inlet in 68. 75% of the patients (44/64). Dental prostheses ingestion (30·0% ) and the impaction at the levelof the second esophageal constriction (43·3% ) weremore encountered in themiddle-to-old aged patients than in patients under the age of 50 (P<0·05). Endoscopies were performed with removal of foreign bodies in 59 patients; foreign bodies were extracted under open esophagotomy in 3 patients; 2 patients were referred to other hospitals.Esophageal perforation occurred in 6 patients, which was resulted from the impaction in 4 patients and the procedure for foreign body removal in 2 patients. Five out of 6 patients with esophageal perforation were cured by conservative treatment.　 Conclusions　A thorough understanding ofmedical history, the location of impaction and types of foreign bodies, as well as an appropriate selection of anesthesia, endoscopy and procedure, is essential to the removal of esophageal foreign bodies and the prevention of complications.

参考文献/References:

[1]石孟志, 郭风春. 老年食管异物124例临床分析. 中国耳鼻咽喉颅底外科杂志, 1997, 3:239-240.
[2]Logemann JA. Upper Digestive Tract Anatomy and Physiology. In: Byron Bailey,ed.Head and Neck Surgery - Otolaryngology. 2nd ed. New York:Lippincott-Raven, 2002. 471-477.
[3]黄益灯,周水淼,张速勤,等. 嵌顿性食管义齿异物治疗体会. 临床耳鼻咽喉科杂志,2003, 17:372-373.
[4]尹海军,刘宏,张彬,等.异物致食管破裂并发液气胸的外科治疗.青岛大学医学院学报,1998,34:142.

更新日期/Last Update: 2014-03-11