301例食管异物患者临床诊治分析

Clinical diagnosis and treatment for esophageal foreign body in 301 cases

目的回顾性分析301例食管异物患者的临床资料，探讨食管异物的临床特征，以提高诊治率。方法收集2000年1月～2011年12月收治经x线食管吞钡棉等检查确诊的食管异物患者301例，其中288例患者有明确的异物史，患者均表现为吞咽困难和疼痛；术前均行X线食管吞钡棉明确异物部位，并根据异物所处部位采取不同的手术方式。结果281例患者通过硬质食管镜取出异物，10例患者通过电子胃镜取出异物，4例合并下咽后壁脓肿患者行颈侧切开取出异物，6例患者入院后自行呕出或进入胃内，1例患者术后失血过多而死亡。结论对于食管异物患者应早诊断、早治疗，同时应根据异物的性质及所处部位采用不同的手术方式，避免并发症的发生。

Objective To study clinical features of esophageal foreign body for improving the abilities of diagnosis and treatment for the disease. Methods Clinical data of 301 patients admitted to our department due to esophageal foreign body from Jan. 2000 to Dec. 2011 was analyzed retrospectively. Of all the 301 cases, 185 were male and 116 were female with age ranged from 2 to 70 years. 288 cases had a clear history of esophageal foreign body. All patients had the symptoms of dysphagia and pain. The diagnosis of esophageal foreign body was confirmed via X-ray examination with barium cotton swallowing. The foreign bodies were removed via different methods according to their features. Results The foreign bodies were removed via rigid esophagoscope in 281 cases, electronic gastroscope in 8, and lateral neck incision in 4 with abscess of retropharyngeal space. The foreign bodies were coughed out or swallowed into stomach in 6 cases and one patient died of excessive hemorrhage. Conclusions Esophageal foreign body should be diagnosed as early as possible and managed timely. To avoid complications especially serious complications, the treatment strategy should he individualized.