成年食管异物住院患者的临床分析
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摘要
目的该研究旨在分析食管内异物住院患者的临床特征、手术方法、相关的并发症、术后住院时间以及多科协作的优势。方法回顾性分析71例食管内异物住院患者,将患者分为两组(A组,误食异物24 h内得到有效治疗;B组,误食异物超过24 h得到有效治疗)。比较两组患者的病历资料、食道异物的种类、并发症和术后住院时间方面的差异。结果最常见的异物为枣核、动物骨头和鱼骨。食管上段异物常见,其中A组比B组更常见。两组间的并发症发生率和术后住院时间存在明显差异。B组患者并发症发生率高,术后住院时间长,多科协作治疗能给患者提供更合适的治疗方法。结论大多数食管内异物能在内镜下取出,24 h内有效的治疗能减少并发症和缩短术后住院时间,消化内科、耳鼻喉科及胸外科多科协作能给患者提供有效安全的治疗。
Objective To analyze the clinical characteristics, surgical methods, related complications, postoperative hospitalization time and the advantages of multidisciplinary collaboration in patients with esophageal foreign bodies. Methods A retrospective analysis of 71 cases of hospitalized patients with esophageal foreign bodies was made. The patients were divided into two groups(Group A, the effective treatment of foreign bodies within 24 hours of ingestion of foreign body; Group B, edible foreign bodies more than 24 hours to be given effective treatment). The two groups were compared the differences of the clinic record data, the types of esophageal foreign bodies, the complications, the postoperative hospitalization time. Results The most common foreign bodies were jujube pits, poultry bones and fish bones. Foreign bodies were common in the upper esophageal segment, of which A group was more common than B group. The incidence of complications and the postoperative hospitalization time between the two groups were significantly different. Patients of Group B with higher incidence of complications, longer postoperative hospitalization stays. Multidisciplinary collaboration could provide the patients with the more appropriate treatment. Conclusions Most intra-esophageal foreign bodies can be removed under endoscope. Effective treatment within 24 hours can reduce the complications and shorten the postoperative hospitalization time. Multidisciplinary collaboration of Department of gastroenterology, otolaryngology and thoracic surgery can provide more effective and safer treatment for the patients with esophageal foreign bodies.
Objective To analyze the clinical characteristics, surgical methods, related complications, postoperative hospitalization time and the advantages of multidisciplinary collaboration in patients with esophageal foreign bodies. Methods A retrospective analysis of 71 cases of hospitalized patients with esophageal foreign bodies was made. The patients were divided into two groups(Group A, the effective treatment of foreign bodies within 24 hours of ingestion of foreign body; Group B, edible foreign bodies more than 24 hours to be given effective treatment). The two groups were compared the differences of the clinic record data, the types of esophageal foreign bodies, the complications, the postoperative hospitalization time. Results The most common foreign bodies were jujube pits, poultry bones and fish bones. Foreign bodies were common in the upper esophageal segment, of which A group was more common than B group. The incidence of complications and the postoperative hospitalization time between the two groups were significantly different. Patients of Group B with higher incidence of complications, longer postoperative hospitalization stays. Multidisciplinary collaboration could provide the patients with the more appropriate treatment. Conclusions Most intra-esophageal foreign bodies can be removed under endoscope. Effective treatment within 24 hours can reduce the complications and shorten the postoperative hospitalization time. Multidisciplinary collaboration of Department of gastroenterology, otolaryngology and thoracic surgery can provide more effective and safer treatment for the patients with esophageal foreign bodies.
引文
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[11]闫秀娥,王丽,周丽雅,等.171例食管上段异物的内镜治疗[J].北京大学学报(医学版),2014,46(1):160-164.[11]YAN X E,WANG L,ZHOU L Y,et al.Analysis for 171 cases of esophageal foreign bodies impacted in upper esophagus with Endoscopic treatment[J].J Peking University(Healths Sciences),2014,46(1):160-164.Chinese
[12]BIANCARI F,D’ANDREA V,PAONE R,et al.Current treatment and outcome of esophageal perforations in adults:systematic review and meta-analysis of 75 studies[J].World J Surg,2013,37(5):1051-1059.
[13]PALTA R,SAHOTA A,BEMARKI A,et al.Foreign-body ingestion:characteristics and outcomes in a lower socioeconomic population with predominantly intentional ingestion[J].Gastrointest Endosc,2009,69(3 Pt 1):426-433.
[2]KIM H U.Oroesophageal fish bone foreign body[J].Clin Endosc,2016,49(4):318-326.
[3]王利利,龚巍,冯永,等.食管异物严重并发症临床分析[J].中华耳鼻咽喉头颈外科杂志,2015,50(6):507-510.[3]WANG L L,GONG W,FENG Y,et al.Clinical analysis of severec complications induced by esophageal foreign bodies[J].Chin JOtorhionlarygol Head Neck Surg,2015,50(6):507-510.Chinese
[4]古庆家,樊建刚,李静娴,等.食道异物并发食管穿孔及颈部脓肿临床分析[J].临床耳鼻咽喉头颈外科杂志,2014,28(7):459-461.[4]GU Q J,FAN J G,LI J X,et al.Clinical analysis of esophageal perforation and neck abscess induced by esophageal foreign body[J].J Clin Otorhinolarygol Head Neck Surg,2014,28(7):459-461.Chinese
[5]KIM J P,KWON O J,SHIM H S,et al.Analysis of clinical feature and management of fish bone ingestion of upper gastrointestinal tract[J].Clin Exp Otorhinolaryngol,2015,8(3):261-267.
[6]CHIU Y H,HOU S K,CHEN S C,et al.Diagnosis and endoscopic management of upper gastrointestinal foreign bodies[J].Am J Med Sci,2012,343(3):192-195.
[7]LI Z S,SUN Z X,ZOU D W,et al.Endoscopic management of foreign bodies in the upper GI tract:experience with 1088 cases in China[J].Gastrointest Endosc,2006,64(4):485-492.
[8]UMIHANI??,BRKI?F,UMIHANI??,et al.Foreign body impaction in esophagus:experiences at ear-nose-throat clinic in Tuzla,2003-2013[J].Kulak Burun Bogaz Ihtis Derg,2015,25(4):214-218.
[9]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(3):131-137.
[10]EROGLU A,CAN KüRK?üOGU I,KARAOGANOGU N,et al.Esophageal perforation:the importance of early diagnosis and primary repair[J].Dis Esophagus,2004,17(1):91-94.
[11]闫秀娥,王丽,周丽雅,等.171例食管上段异物的内镜治疗[J].北京大学学报(医学版),2014,46(1):160-164.[11]YAN X E,WANG L,ZHOU L Y,et al.Analysis for 171 cases of esophageal foreign bodies impacted in upper esophagus with Endoscopic treatment[J].J Peking University(Healths Sciences),2014,46(1):160-164.Chinese
[12]BIANCARI F,D’ANDREA V,PAONE R,et al.Current treatment and outcome of esophageal perforations in adults:systematic review and meta-analysis of 75 studies[J].World J Surg,2013,37(5):1051-1059.
[13]PALTA R,SAHOTA A,BEMARKI A,et al.Foreign-body ingestion:characteristics and outcomes in a lower socioeconomic population with predominantly intentional ingestion[J].Gastrointest Endosc,2009,69(3 Pt 1):426-433.