磁性异物致消化道损伤的地理和社会环境因素分析

Analysison the geographical and social environment of cases of GUT injuries caused by swallowing multiple magnetic foreign objects

目的研究误吞磁性异物病例发生的地理分布和社会环境因素及其对儿童健康的影响。方法研究了国内外所有以英文和中文发表的关于磁性异物导致消化道损伤的文献,包括发病年龄、性别、国家和地区分布、磁性异物的数量、磁性异物来源、临床诊疗过程。结果共收集了来自15个国家和地区的79例磁性异物吞咽病例,其中美国发病率最高(49.3%),其次是日本(18.9%)。所吞咽的磁性异物来源包括玩具(76%)、医疗仪器(10%)和饰品(10%)等,消化道损伤包括了从食道至结肠等不同部位的穿孔、肠瘘、腹膜炎等并发症,导致严重机体损伤。结论误吞磁性异物病例有着明显的地理分布特征,异物来源与社会文化背景有一定的关系。2枚以上的磁体吞入消化道,由于磁力的作用,可能导致严重消化道损伤,因此需要早期明确诊断并进行内镜或手术治疗。防止磁体误吞是消除危害的根本措施。

Objective To study the geographical distribution and social environment of cases of GUT injuries caused by swallowing multiple magnetic foreign objects and the influences upon children＇s health. Methods The author surveyed radiologists and researchedabout the domestic and foreign literature of magnets swallowing, and the documented clients＇ age, gender, territories, numbers of magnets, source of the magnets, removal methods and clinical operation. Results A total of 79 instances of magnets swallowing from 15 countries and regions were collected. Magnet swallowing occurred throughout childhood, with most children younger than 6 years . Of all the selected countries, USA is of the highest morbidity（49.3 %）and then Japan （18. 9 % ）. The majority of thc swallowed magnets are toys（76 % ）, and then medical facility（10 % ）and personal ornaments（10 % ）, which caused a wide range of gut injuries from esophagus to colon, including perforation, intestinal fistula and peritonitis, leading to scrious physical injuries. Conclusion Injury from swallowing multiple magnets is a considerable worldwide issue. These incidences are characterized with obvious geographical distribution and the foreign magnetic objects are featured with diverse cultural and geographical backgrounds. Two or more magnets may cause severe gastrointestinal injury, thus the early diagnosis and treatment by endoscopy or surgery is rather necessary. The prevention of the magnetic objects swallow is the fundamental measure to eliminate the hazards.