儿童误吞高吸水性树脂球32例临床分析

Clinical analysis of 32 cases of ingested super absorbent polymer balls in children

目的总结儿童误吞高吸水性树脂球的临床特点和预后,为临床治疗提供依据和指导。方法回顾性分析山东大学齐鲁儿童医院确诊的32例误吞高吸水性树脂球患儿的临床资料,包括年龄、性别、误吞时间、滞留部位、影像学检查、消化内镜检查、并发症、治疗及转归等。结果32例患儿中,男18例、女14例,平均(2.75±1.55)岁,误吞异物中位时间为5.00(3.25,13.50)h,就诊时异物滞留在小肠及胃最多见。7例(21.88%)出现临床症状及并发症,临床以呕吐、腹胀、腹痛、哭闹、拒食为主要表现,并发症主要是肠梗阻及电解质紊乱。自行排出异物者20例(62.50%),胃镜取出5例(15.63%),外科手术治疗7例(21.88%)。所有患儿预后良好,无死亡病例发生。误吞时间<12 h患儿并发症发生率(16.67%)与误吞时间≥12 h患儿并发症发生率(37.50%)之间差异无统计学意义(P=0.327)。结论高吸水性树脂球对儿童危害性较大,早期明确诊断及干预治疗有助于减少并发症,儿童需要更多的预防措施。

Objective To summarize the characteristics and prognosis of ingested super absorbent polymer balls in children,thus to provide basis and guidance for future clinical treatment.Methods The clinical data of 32 cases of ingested super absorbent polymer balls in children in Qilu Children's Hospital of Shandong University were retrospectively analyzed,including age,gender,time of swallowing,location of foreign body,imaging examination,digestive endoscopy,treatment,complication and prognosis.Results A total of 32 cases of ingested super absorbent polymer in children were collected,including 18 males and 14 females,mean age was(2.75±1.55)years,median time of swallowing was 5.00(3.25,13.50)h.Foreign bodies were mainly lodged in the small intestine and the stomach.Clinical symptoms and complications were found in 7 patients(21.88%).Symptoms included vomiting,abdominal distension,abdominal pain,crying,and refusal to eat;complications were mainly intestinal obstruction and electrolyte disturbance.Totally 20 cases(62.50%)discharged automatically,5 cases(15.63%)by gastroscope,and 7 cases(21.88%)by surgery operation.All cases had good prognosis and no deaths occurred.The occurance rate of complications in the group with swallowing time<12 hours had no statistical difference with the group with swallowing time≥12 hours(P=0.327).Conclusion Super absorbent polymer balls is harmful to children.Early diagnosis and intervention is helpful to reduce the occurrance of complications.More precautious measures should be taken for children.