婴幼儿上消化道异物内镜取出术的诊治体会

Experences in endoscopic removal of upper digestive foreign bodies in infants

目的总结内镜下婴幼儿上消化道异物取出的方法及技巧。方法采用成人胃镜,静脉麻醉下对14例婴幼儿上消化道异物进行治疗。结果内镜检查3例未见异物,11例异物成功取出。7例硬币中有5例使用鼠齿钳取出,2例使用鼠齿钳+乳胶套的方法取出;1例磁铁片,使用网篮取出;1例大头针,使用橡胶头异物钳+磁性异物钳取出;1例铁钉,使用圈套器取出;1例金属条,使用鼠齿钳+外套管取出。14例患儿均无并发症。结论内镜下婴幼儿上消化道异物取出术是安全的,创伤小、并发症少。针对不同的异物需采用不同的操作工具,可取得事半功倍的效果。

Objective To summarize the experiences of removing infants＇ upper digestive foreign bodies （FBs）. Methods The clinical data of 14 infants who were initially suspected of having upper digestive tract FBs and later un- dergone endoscopic procedures by adult gastroscopy under intravenous anesthesia were retrospectively analyzed. Results During endoscopic procedures, 3 infants were found no upper digestive FBs, and FBs of the other 11 infants were en- doscopically removed in safety. Among 7 infants who had coins stuck in the upper digestive tract, 5 coins were extracted using rat-tooth forceps, and the other 2 coins were retrieved using rat-tooth forceps plus rubber sleeves. The magnet sheet which was swallowed by an infant was removed with a stone retrieval basket. One pin was removed by FB forceps with a rubber head plus magnetic FB forceps. One iron nail was removed by a snare. One metal strip was removed by rat-tooth forceps plus a over tube. No complications were noted in all fourteen procedures. Conclusion Endoscopic re- moval of upper digestive foreign bodies in infants by adult gastroscope is feasible and safe. Techniques of removal de- pend on FBs. Optimal grasping accessories may achieve the procedure with less effort.