纽扣电池所致儿童食管损伤的临床特征及治疗

Clinical characteristics and treatment of esophageal injury caused by button battery in children

目的探讨纽扣电池所致儿童食管损伤的临床特征及治疗方法,旨在提高儿童纽扣电池食管异物的诊断和治疗水平。方法回顾性分析15例纽扣电池食管异物患儿的临床特征、治疗方法及预后。结果硬质食管镜取出纽扣电池12例,电子胃镜下取出纽扣电池3例。12例患儿发生比较严重的食管损伤,10例患儿通过鼻饲、抗炎及支持治疗得到完全恢复。2例术后发生食管穿孔,其中1例并发食管气管瘘。结论纽扣电池嵌顿在食管容易造成严重食管损伤,处理关键是尽快确诊。一旦确诊纽扣电池嵌顿在食管,必须将其取出。纽扣电池在X线片上有比较明显的特征,胸片可作为误吞纽扣电池诊断首选检查。如能根据病情选择合适的手术方式及恰当的术后处理,多数预后良好,但要警惕食管穿孔及食管气管瘘等严重并发症出现。

Objective To study the clinical characteristics and treatment of esophageal injury caused by button battery foreign bodies in children, then improve the diagnosis and management level of this hazardous problem of children. Methods 15 patients with esophageal injury caused by button battery foreign bodies were retrospectively analyzed the clinical characteristics, treatment and prognosis. Results 12 button battery foreign bodies were removed successfully with rigid esophagoscope, 3 with electronic gastroscope. 12 cases occurred serious esophageal lesions, 10 patients were fully recovered after nasal feeding, anti-infammatory and supporting therapy. Serious complication such as esophageal perforation occurred in 2 cases, one of them occurred tracheo-esophageal fistula. Conclusion Button battery embedded in the esophagus is easy to cause serious esophagus injury, early detection is the key of the management, and its prompt removal is mandatory. Button battery have a distinctive appearance on radiography, chest radiographs can be used as the frst choice of diagnosis. The reasonable treatment can obtain better curative results and avoid serious complications according to the course of the disease and esophageal damage degree. Physicians must recognize the hazardous potential and serious implications such as esophageal perforation and tracheo-esophageal fstula.