食管异物234例临床分析

王振晓; 曹晓明; 葛鑫颖; 张奥博; 路承; 白雪; 侯倩; 刘良发

doi:10.13201/j.issn.1001-1781.2019.02.013

食管异物234例临床分析

- 1. 首都医科大学附属北京友谊医院耳鼻咽喉头颈外科(北京, 100032);
- 2. 德州市人民医院耳鼻咽喉科
基金项目:
首都医科大学附属北京友谊医院启动课题 (No:yydszx2015-02)

详细信息

通讯作者: 刘良发,E-mail:liuliangfa301@263.net

中图分类号: R768.3

收稿日期: 2018-10-09

Clinical analysis of 234esophageal foreign bodies

- 1. Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, 100032, China;
- 2. Department of Otolaryngology, Dezhou People's Hospital

More Information

Corresponding author: LIU Liangfa, E-mail: liuliangfa301@263.net

Received Date: 09 October 2018

摘要

摘要: 目的:通过对234例食管异物病例进行分析,探讨食管异物患者的临床特点,提高诊疗水平。方法:回顾性分析234例食管异物患者的临床资料,包括发病时间、异物类型、治疗方式及相关并发症的影像学表现。结果:234例患者术前均行颈部CT或食管钡餐X线检查以明确食管异物诊断,发病时间为3h~7d,其中以食源性异物中的枣核占大多数。2例患者因症状消失或减轻,而未行手术治疗。223例患者经静脉全身麻醉行食管镜探查+异物取出术,其中11例未见明确食管内异物,22例出现食管穿孔及食管周围炎,取出异物后予以胃管置入,术后约10d行碘油造影示无明确造影剂食管外泄后拔除胃管;9例合并颈部脓肿者经全身麻醉气管插管下行颈侧脓肿切开探查+引流术,其中1例术腔未见明确异物,患者术后平均17.8d痊愈出院。结论:经静脉全身麻醉硬质食管镜下异物取出是治疗食管异物安全、有效的方法,对出现食管穿孔伴颈部脓肿等严重并发症者,应及时行全身麻醉气管插管下颈侧脓肿切开探查+引流术,并进行积极对症支持治疗,患者预后良好。
- 食管 /
- 异物 /
- 并发症
Abstract: Objective:To explore the clinical characteristics and treatment methods of esophageal foreign body.Method:The clinical data of 234patients with esophageal foreign bodies admitted to our department from January 2015to August 2018were retrospectively analyzed, including course time, foreign body types, surgical methods, imaging manifestations and treatment related complications.Result:The diagnosis of esophageal foreign bodies was confirmed by esophageal CT or esophageal barium meal X-ray examination before operation in 234patients.Course time varied from 3hours to 7days, and the jujube nucleus was the most common food-borne foreign body.223patients underwent esophagoscopic exploration and foreign body removal under general intravenous anesthesia, 11of them had no definite esophageal foreign body, 22had esophageal perforation and periesophagitis.After removal of foreign body, the nasogastric feeding tube was inserted.About 10days later, the nasogastric feeding tube was removed when they got healthy.Nine cases underwent cervical abscess incision and drainage under general anesthesia.The average postoperative hospital day was 11days.Conclusion:The rigid esophagoscopy is a safe and effective method for the esophageal foreign bodies.And neck abscess incision must be necessary, when they suffered from esophageal perforation with neck abscess and other serious complications.
- esophageal /
- foreign bodies /
- complication

HTML全文

参考文献(18)

[1]	葛鑫颖, 刘良发, 路承, 等.食管异物穿孔致颈深间隙感染及纵隔脓肿的诊治[J].临床耳鼻咽喉头颈外科杂志, 2018, 32 (4):292-294.
[2]	LONGSTRETH G F, LONGSTRETH K J, YAO J F.Esophageal food impaction:epidemiology and therapy.A retrospective, observational study[J].Gastrointest Endosc, 2001, 53:193-198.
[3]	BIRK M, BAUERFEIND P, DEPREZ P H, et al.Removal of foreign bodies in the upper gastrointestinal tract in adults:European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline[J].Endoscopy, 2016, 48:489-496.
[4]	BENMANSOUR N, OUATTASSI N, BENMLIH A, et al.Vertebral artery dissection due to an esophageal foreign body migration:a casereport[J].Pan Afr Med J, 2014, 17:96-96.
[5]	STILES B M, WILSON W H, BRIDGES M A, et al.Denture esophageal impaction refractory to endoscopic removal in a psychiatric patient[J].J Emerg Med, 2000, 18:323-326.
[6]	ATHANASSIADI K, GERAZOUNIS M, METAXAS E, et al.Management of esophageal foreign bodies:a retrospective review of 400cases[J].Eur J Cardiothorac Surg, 2002, 21:653-656.
[7]	贾军, 张楠楠, 王永良, 等.食管异物124例临床分析[J].临床耳鼻咽喉头颈外科杂志, 2015, 29 (18):1652-1653.
[8]	WU W T, CHIU C T, KUO C J, et al.Endoscopic management of suspected esophageal foreign body in adults[J].Dis Esophagus, 2011, 24:131-137.
[9]	李四军, 潘庆春, 严达忠, 等.食管异物312例临床分析[J].临床耳鼻咽喉头颈外科杂志, 2017, 31 (7):556-559.
[10]	董科, 应明亮, 周绍斌, 等.螺旋CT后处理技术对诊疗食管异物的临床增益价值[J].放射学实践, 2012, 27 (12):1328-1330.
[11]	PARK J H, PARK C H, PARK J H, et al.Review of 209 cases of foreign bodies in the upper gastrointestinal tract and clinical factors for successful endoscopic removal[J].Korean J Gastroenterol, 2004, 43:226-233.
[12]	毛弈韬, 聂智樱, 杨福伟, 等.食管异物引起严重并发症的临床分析[J].临床耳鼻咽喉头颈外科杂志, 2012, 26 (24):1111-1112.
[13]	STEWART K C, URSCHEL J D, FISCHER J D, et al.Esophagotomy for incarcerated esophageal foreign bodies[J].Am Surg, 1995, 61:252-253.
[14]	NADIR A, SAHIN E, NADIR I, et al.Esophageal foreign bodies:177cases[J].Dis Esophagus, 2011, 24:6-9.
[15]	OKTEN I, CANGIR A K, OZDEMIR N, et al.Management of esophageal perforation[J].Surg Today, 2001, 31:36-39.
[16]	BADDOUH N, ARJDAL L, RAJI A, et al.Unsuspected cause of respiratory distress:unrecognized esophageal foreign body[J].Case Rep Pediatr, 2018, 2018:6283053.
[17]	NAKASHABENDI I M, MALDONADO M E, BRADY P C.Chest pain overlooked manifestation of unsuspected esophageal foreign body[J].South Med J, 2001, 94:333-335.
[18]	LI Z S, SUN Z X, ZOU D W, et al.Endoscopic management of foreign bodies in the upper-GI tract:experience with 1088cases in China[J].Gastrointest Endosc, 2006, 64:485-492.