食管异物127例临床诊治分析

Clinical management of esophageal foreign body in 127 cases

摘要:

目的 探讨食管异物（EFB）的临床特点及治疗方法，提高临床诊治水平，降低并发症的发生，为EFB的合理化、规范化治疗提供临床依据。方法 收集兰州大学第一医院2017年9月—2019年12月收治的127例EFB患者的临床资料、治疗方法及并发症的情况，对其性别、年龄、异物种类、术前检查方法、嵌顿部位、嵌顿时间、临床症状、并发症及住院日等资料进行整理分析。结果 127例EFB患者，男64例，女63例，男女比例1.02：1；年龄1~85岁，平均年龄（35.9±27.0）岁。就诊时间：24 h内103例（81.1%），24~72 h内10例（7.9%），>72 h的14例（11%）。异物种类：枣核27例（21.3%），鸡骨25例（19.7%），义齿23例（18.1%），硬币22例（17.3%），金属物品10例（7.8%），肉块5例（3.9%），纽扣电池3例（2.4%），其余12例（9.5%）。嵌顿部位：第1狭窄84例（66.1%），第2狭窄43例（33.9%）。结论 加强看护和健康宣教是预防EFB发生的关键，及时准确的诊断治疗、多学科间的合作对EFB的预后和并发症至关重要。

Abstract:

Objective To discuss the clinical features and treatment methods of esophageal foreign bodies so as to improve the ability of clinical diagnosis and treatment, reduce the incidence of complications and, furtherly, to provide some clinical evidences for the rationalization and normalization of treatment of esophageal foreign bodies. Methods The clinical data, treatment methods and complications of 127 cases with esophageal foreign bodies treated in the First Hospital of Lanzhou University from Sept 2017 to Dec 2019 were collected. The patients' age and gender, types of foreign bodies, preoperative examination, location and duration of foreign body impaction, clinical symptoms, complications and hospital stay were analyzed retrospectively. Results Of the 127 cases, 64 were male and 63 were female with a male to female ratio of 1.02:1. Their age range was between 1 and 85 years old with an average age of 35.9±27.0. One hundred and three cases (81.1%) visited a doctor within 24 hours of forein body incarceration, 10 (7.9%) in 24 to 72 hours, and 14 (11%) beyond 72 hours. The types of foreign bodies included jujube pit (27, 21.3%), chicken bone (25, 19.7%), denture (23, 18.1%), coin,(22, 17.3%), metal object (10, 7.8%), meat loaf (5, 3.9%), button battery (3, 2.4%) and others (12, 9.5%). The foreign bodies were incarcerated at the first narrowing of the esophagus in 84 cases (66.1%) and the second narrowing in 43 (33.9%). Conclusions To strengthen nursing and health education is the key for the prevention of esophageal foreign body. Timely diagnosis, proper and prompt treatment as well as multidisciplinary cooperation are crucial to the prognosis of esophageal foreign body.