小儿食管光滑异物3种治疗方法的临床分析

Removal of smooth esophageal foreign body in children with three different methods

目的比较3种治疗小儿食管光滑异物方法的疗效及优缺点。方法对1 8 1例小儿食管光滑异物分别采用Foley管、电子食管胃镜及硬质食管镜进行治疗。结果1 2 1例光滑异物中应用Foley管法成功取出1 0 8例(8 9.3%),平均操作时间6.2 m in,5例出现鼻出血、唇黏膜损伤等轻微并发症,未见严重并发症发生;3 7例电子食管胃镜成功取出3 2例(8 6.5%),8例出现并发症,其中1例为食管穿孔;2 3例使用硬质食管镜顺利取出异物2 2例(9 5.7%),6例术中出现呼吸困难,4例食管黏膜损伤,1例牙齿脱落,其疗效与Foley管、电子食管胃镜组比较差异有统计学意义(P<0.0 5)。结论Foley管治疗小儿食管光滑异物具有安全、有效、操作简单等特点。

Objective To compare the efficacy and advantages of three methods applied to the removal of smooth esophageal foreign body in children. Methods 181 children with smooth esophageal foreign body underwent the removal of foreign body with three different methods of Foley catheter, electrogastroscope, or rigid esophagoscopy . Results Of 1 2 1 cases with Foley catheter , successful removal was performed in 1 0 8 （ 89. 3 % ） with an average operation time of 6. 2 minutes, and no major complications occurred except a few minor complications including epistaxis and mucosal injury of lip in 5 cases. The successful rate of removal with electrogastroscope was 86. 5 % （ 32 / 37 ） , and complications occurred in 8 cases including esophageal perforation in one case. Removal with rigid esophagoscopy was applied to 23 patients and successful in 22 （95. 7 % ）. While the efficacy of the last method was significantly higher than that of the former two （ P 〈 0. 05 ） , more and serious complications including dyspnea （in 6 cases ） , esophageal mucosa injury （in 4 cases ） , and loss a tooth （in one case ） were also encountered. Conclusion Removal of smooth esophageal foreign bodies in children with Foley catheter is safe, effective and simple.