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摘要: 目的:提高对儿童扣式电池消化道异物的诊疗水平。方法:14例扣式电池消化道异物中,食管6例,胃、下消化道7例,食管、胃多发异物1例,平均年龄2岁1个月。胃、下消化道异物7例未予特殊处理,密切观察;食管异物6例在全身麻醉下行食管镜检+异物取出术;食管、胃多发异物1例行食管镜和电子胃镜异物取出术。取出后均行对症治疗。结果:胃、下消化道异物7例1~2 d自行排出;食管异物6例,4例取出治愈,1例取出后出现食管狭窄,1例死亡;食管、胃多发性异物1例,取出后治愈。结论:扣式电池食管异物腐蚀性强,危害大,易危及患儿生命及形成食管狭窄,及时诊断、合理手术是治愈的关键。扣式电池胃、下消化道异物由于消化液的中和,嵌顿概率低,密切观察,多可自行排出。Abstract: Objective: To improve diagnosis and treatment level of foreign body ingestion of button cell in children.Method: Among the 14 cases with foreign bodies ingestion of button cell,6 cases in esophagea,7 cases in stomach and lower gastrointestinal tract,1 case with multiple foreign bodies both in esophagus and stomach. Seven cases in stomach and lower gastrointestinal tract were closely observed without special treatment, 6 cases in esophageal, underwent esophagoscopy and removal of foreign body under general anesthesia, 1 case with multiple foreign bodies in esophagus and stomach underwent esophagoscopy and electronic gastroscopy and then removal of foreign body. All patients had symptomatic treatments after removal of foreign body The average age is 2 years and 1 month.Result: After the removal of button cell, Foreign bodies in stomach and lower gastrointestinal tract in 7 cases were all discharged spontaneously. For the 6 cases in esophagus, 4 cases were cured, 1 case had esophageal stricture, 1 cased died. 1 case with multiple foreign bodies in both esophagus and stomach was cured.Conclusion: Esophageal foreign body has strong corrosiveness and would cause serious damages even to threaten children's life. It also may lead to esophageal stricture. The key point to cure this disease is to diagnose timely and to operate as soon as possible. Because neutralize of digestive juices and low probability of incarceration, with close observation, the foreign bodies of stomach and lower gastrointestinal tract can discharge spontaneously.
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Key words:
- button cell /
- children /
- gastrointestinal foreign bodies
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[1] SAMAD L,ALI M,RAMZI H.Button battery ingestion:hazards of esophageal impaction[J].J Pediatr Surg,1999,34:1527-1531.
[2] 饶凯成,李隽.儿童扣式电池食管异物临床分析[J]. 临床耳鼻咽喉头颈外科杂志,2010,24(9):409-410.
[3] EISEN G M, BARON T H, DOMINITZ J A,et al. Guideline for the management of ingested foreign bodies[J]. Gastrointest Endosc,2002,55:802-806.
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