大理大学学报 ›› 2020, Vol. 5 ›› Issue (2): 1-5.DOI: 10. 3969 / j. issn. 2096-2266. 2020. 02. 001

• 中华医学会2019年小儿外科西部行专栏 •    下一篇

儿童消化道异物112例临床特点及治疗经验分析

刘 丹,曲 媛,白玉作,贾慧敏 *   

  1. (中国医科大学附属盛京医院小儿普外科,沈阳 110004)
  • 收稿日期:2019-03-25 修回日期:2019-08-04 出版日期:2020-02-15 发布日期:2020-02-15
  • 通讯作者: 贾慧敏,教授,博士,E-mail:jiahuiminmm@163.com。
  • 作者简介:刘丹,博士研究生,主要从事小儿普外胸外科和先天性肛门直肠畸形研究。

Clinical Characteristics and Treatment Experience of 112 Children with Foreign Bodies in Digestive Tract

Liu Dan, Qu Yuan, Bai Yuzuo, Jia Huimin *   

  1. (Department of Pediatric General Surgery, Shengjing Hospital of China Medical University, Shenyang 110004, China)
  • Received:2019-03-25 Revised:2019-08-04 Online:2020-02-15 Published:2020-02-15

摘要: 目的:探讨儿童消化道异物的临床特点与治疗方法的选择。方法:回顾性分析2012年1月至2018年6月期间收入中国
医科大学附属盛京医院治疗 112例消化道异物患儿的临床资料,112例中,食道异物83例、胃十二指肠内异物7例和肠道异物
22例,90例食道和胃十二指肠内异物均实施经内镜取出术,22例肠道异物中保守治疗14例,手术治疗8例。结果:85例异物根
据存留部位有不同的表现,27例无症状,均根据误吞异物史和影像学做出诊断。经内镜取异物的90例均安全取出,保守治疗
14例平均6.3 d经肛门排除异物,无中转开放手术者,手术治疗8例异物取出顺利,术中可见异物位于空肠3例、回肠4例、盲肠
1例。术后并发症切口化脓2例,所有患儿均痊愈出院。结论:儿童误吞异物后临床表现差异较大,需根据异物的大小、性质、
位置、病程时间及临床表现综合决定治疗方案,但无症状异物可密切观察期待自行排除,而发生严重并发症时需积极干预。

关键词: 消化道异物, 临床特点, 诊断与治疗, 儿童

Abstract: Objective: To explore the clinical characteristics and treatment of foreign bodies in children′s digestive tract. Methods:
Clinical data of 112 cases of children with foreign bodies in digestive tract admitted to Shengjing Hospital of China Medical University
from January 2012 to June 2018 was retrospectively analyzed. Among the 112 cases, 83 were of foreign bodies in the esophagus, 7 were
of foreign bodies in the gastroduodenum, and 22 were of foreign bodies in intestinal tract. The 90 cases of foreign bodies in the
esophagus and gastroduodenum were treated with endoscopic removal. Among the 22 cases of foreign bodies in intestinal tract, 14
received conservative treatment and 8 underwent surgeries. Results: 85 cases of foreign body showed different manifestations
depending on the location, 27 cases were asymptomatic, and all were diagnosed based on history of mistakenly swallowed foreign bodies
and imaging. 90 cases of foreign body removal by endoscope were safely removed. 14 cases were conservatively treated for an average of
6.3 d and the foreign bodies were excreted through the anus. No open surgery was performed. 8 cases of foreign body removal through
surgeries were successfully treated, among which the foreign bodies were found in the jejunum in 3 cases, in the ileum in 4 cases, and
in the cecum in 1 case. Postoperative complications of incision and suppuration happened in 2 cases, and all children were cured and
discharged. Conclusion: Children′s clinical manifestations vary greatly after swallowing foreign bodies. Comprehensive treatment
decisions need to be made based on the size, nature, location, duration of disease. Asymptomatic foreign bodies can be closely
observed, but active intervention is required when serious complications occur.

Key words: foreign bodies in digestive tract, clinical characteristics, diagnosis and treatment, children