小儿误食枣核致消化道穿孔8例临床分析

Analysis of clinical data in 8 patients with gastrointestinal perforation due to accidental ingestion of jujube seed

目的探讨小儿误食枣核导致消化道穿孔的临床特点及治疗方法。方法回顾性分析本院自2015年2月至2016年1月间收治的8例误食枣核导致消化道穿孔患儿的临床资料。结果8例患儿中,男性5例,女性3例,年龄1.5~3.8岁,平均年龄2.6岁。包括:十二指肠升部穿孔1例,行穿孔修补术;回肠穿孔6例,其中1例腹腔镜下行穿孔修补术,1例腹腔镜辅助下行肠切除、肠吻合术,1例行开腹常规肠切除、肠吻合术,3例行肠造瘘术;盲肠穿孔1例,行肠造瘘术。8例患儿术后均恢复良好;其中4例肠造瘘术患儿二次手术,行肠造瘘关瘘术,恢复顺利,随访半年,无并发症。结论对于误食枣核导致消化道穿孔病例,需要详细询问病史,仔细体格检查,结合相关影像学资料及血液化验检查,争取早期确诊,早期手术,同时应做好相关健康宣教,让家属认识到枣核的危害性,避免悲剧重演。

Objective To explore the clinical features and treatment modalities of gastrointestinal perfo- ration due to accidental ingestion of jujube seed. Methods Retrospective analysis was performed for clinical data of 8 cases of gastrointestinal perforation due to accidental ingestion of jujube seed. Results Eight cases were diagnosed as gastrointestinal perforation due to accidental ingestion of jujube seed. One case of duodenal perforation at ascending duodenum was repaired. Among 6 cases of ileal perforation, the procedures of laparo- scopic repair （ n = 1 ） , laparoseopic intestinal resection ＆ anastomosis （ n = 1 ） , open intestinal resection ＆ anas- tomosis （ n = 1 ） and enterostomy （ n = 3 ） were performed. Postoperative recovery was smooth. M1 4 enteros- tomic patients underwent secondary anastomosis and recovered smoothly. During a postoperative follow-up peri- od of 6 months,there was no onset of complications. Conclusions Detailed history-taking, thorough physical examinations, imaging studies and blood tests may aid an early diagnosis. Timely surgery is life-saving. At the same time, health education should be offered through various channels. All family members should recognize the danger of jujube seed and prevent the recurrence of tragedy.