471例食管异物内镜下取出术的分析及术中护理配合

Analysis of foreign body removal in esophagus under endoscope in 471 patients and nursing cooperation

目的对471例食管异物患者进行内镜异物取出术,按食管3个生理狭窄进行分段治疗,总结术中护理配合要点。方法根据异物不同形态、性质、大小,在内镜下选用不同器械将异物取出。结果 471例患者中431例在门诊顺利取出,其中15例异物取出后收住院观察,8例住院后再行异物取出术。431例异物取出的患者均无并发症发生。6例因异物嵌顿于主动脉弓段,且嵌顿处黏膜损伤明显,转入胸外科手术治疗,11例因食管上段异物内镜下无法取出,转入五官科就诊。结论完善食管异物的诊疗流程,按程序进行诊断治疗至关重要。食管异物取出术应充分重视术前的评估,根据评估结果选择合适的器械,合适的方法,及时准确熟练配合,可及时解除患者的痛苦,有效防止并发症的发生。

Objective To summarize the intraoperative nursing cooperation for 471 patients who received phrasal foreign body removal in esophagus under endoscope according to the physiological stricture of the esophagus.Methods According to the shape,property and size of different foreign bodies,different endoscopic instruments were used.Results Of 471 patients,431 patients were successfully treated in outpatients,15 patients were hospitalized after removal of foreign bodies,and 8 patients were hospitalized before their foreign bodies were removed.No complications occurred in 431 patients.Six patients had foreign bodies incarcerated in the segment of aortic arch with obvious mucosal injuries,and were transferred to thoracic surgery department for surgical treatment.Foreign bodies were in the upper esophagus of 11 patients and could not be removed under endoscope.Those patients had to be transferred to ENT department for further treatment.Conclusion It is important to improve the process of the diagnosis and treatment of foreign body in esophagus and strictly follow procedures.Adequate attention should be paid to the preoperative evaluation of such foreign body removal surgeries.Based on the results of such evaluation,appropriate equipment and proper approach should be chosen.Together with timely and accurate nursing cooperation,the pains of patients can be released and the complications can be effectively prevented.