食管异物1252例临床分析

Clinical Analysis of Esophageal Foreign Bodies: a Retrospective Review of 1 252 Cases

目的:通过回顾分析1252例食管异物患者临床资料,探讨食管异物的特点以及相应的治疗方法。方法:收集1965～2003年收治的食管异物1252例,其中男性862例,女性390例,年龄4个月～81岁。大多数患者有明确的异物史,主要症状是吞咽困难和疼痛。所有患者均行X线检查确诊。绝大多数患者(98.6%)通过硬管食管镜取出异物。其中59例患者行全身麻醉,其余均为表面麻醉。结果:所有病例中出现严重并发症29例(2.3%),其中食管穿孔24例(继发颈深脓肿5例,纵隔脓肿5例),咽后脓肿4例,梨状窝穿通1例,死亡1例(0.08%)。结论:①早期食管镜检查是治疗食管异物最有效的方法;②对并发症及时准确的诊治是治疗关键;③全身麻醉可以减少并发症的发生;④必要的外科手术干预可预防严重并发症的出现。

Objective： A retrospective study was conducted in 1 252 patients with esophageal foreign bodies（EFB） to assess characteristics of EFB and methods of treatment. Methods： From 1965 to 2003, 1 252 patients with esophageal foreign bodies （EFB） were treated. There were 862 men（68.8%） and 390 women（31.2%） ranging in age from 4 months to 81 years. The majority of the patients had a clear history. The main symptoms were difficulty of swallowing and pain. All of patients were performed X-ray examination. Majority of patients （98. 6% ） were treated with rigid esophagoscopy and FBs were removed successfully, in which 1176 cases were under superficial anesthesia and 59 cases under general anesthesia. Results.. In these cases, the majority were treated successfully. But some serious complications occurred in 29 cases （2.3%）. The first one was esophageal perforation in 24 cases. The others were postpharyngeal abscess （4 cases） and pearformed socket puncture （1 case）. In our series, one patient was dead. Mortality reached 0. 08%. Conclusion：①Esophagoscopy is a reliable method in the treatment of EFB at early time.②Early and accurate diagnosis and treatment for the complications are very important. ③General anesthesia can reduce complications.④Selective surgery can prevent serious complications.