咽部食管腔外异物临床诊治体会

Diagnosis and treatment of migrating ingested foreign body in jaw and neck in 9 patients

目的探讨消化道外食源性异物的临床特点和诊治策略,以期提高临床诊治水平。方法回顾性分析9例颌颈部消化道外食源性异物病历资料,从病史、临床诊断、治疗方法及预后等方面进行总结。结果 9例患者病史6 d至15个月不等;其中6例主动提供误吞异物史,2例在影像检查怀疑异物后追问病史再提供,1例未提供;其中8例经薄层CT扫描怀疑异物,1例术后方明确为异物;8例采用手术治疗患者,7例取出异物且预后佳,1例手术失败未取出异物,但随访至今无不适,另1例采用保守治疗,随访至今无不适。结论详尽地追问病史并综合应用多种辅助检查手段,尤其是多层螺旋CT薄层扫描,可提高本病诊断的成功率。

Objective To investigate the clinical features and strategies of diagnosis and treatment of migrating ingested foreign body for improving the successful rate of diagnosis and treatment for this disease. Methods Clinical data of 9 patients with migrating ingested foreign body in jaw and neck diagnosed and treated in our hospital were analyzed retrospectively. The data included medical history,clinical diagnosis,treatment,and prognosis. Results The medical courses ranged from 6 days to 15 months. Of them,6 offered history of swallowing foreign body by mistake,2 offered the history after imaging examination with prompting for foreign body,and one denied the history. The diagnosis was established by multislice spiral CT in 8 patients and by surgical finding in one. 8 patients received surgical treatment.Foreign bodies were successfully removed from 7 patients and the effects were satisfactory. Foreign body could not be detected during operation in one case who had no discomfort during the follow-up period. One patient with conservative treatment didn＇t have any discomfort. Conclusion It is essential for the diagnosis of migrating ingested foreign body to question medical history in detail with integrated application of auxiliary examinations,especially multislice spiral CT.