儿童食管异物的临床治疗分析

The clinical analysis of esophageal foreign body in children

目的讨论儿童食管异物的临床症状、诊治方法及并发症的处理。方法选取2013年01月～2018年06月本院收治并有完善临床资料的食管异物患儿233例作为研究对象,进行临床分析。结果选取233例患儿中,共行236例手术治疗,其中一例患儿行4次食管异物取出术。根据异物种类及卡顿时间选择不同的手术方式,积极处理术后发生并发症,其中食管穿孔3例,气管食管瘘2例,纵隔气肿及颈部皮下气肿3例,颈部脓肿1例。其中2例合并气管食管瘘患儿转至外院行胃造瘘及食管修补术治疗。其余患儿在我科行抗感染、鼻饲、营养支持治疗后痊愈出院。术后随访三月,回访结果满意。结论获取详细病史;及早选择合适的手术治疗;积极开展多学科联合诊疗,才能提高儿童食管异物的诊疗成功率,减少并发症的发生。

Objective Discuss clinical symptoms, diagnosis and treatment methods of esophageal foreign body in children and deal with the complications.Methods Selection of jan select 01,2013 to jun 2018 in our hospital were analyzed and the improving the clinical data of 233 cases of esophageal foreign body with clinical analysis.Results Line selection in 233 cases, a total of 236 surgical treatment, children with one row four esophageal foreign bodies. According to the kinds of foreign bodies and times choose different ways of operation, postoperative complications, including 3 cases of esophageal perforation, tracheoesophageal fistula in 2 cases, mediastinal emphysema and neck subcutaneous emphysema (3 cases), cervical abscess in 1 case. Postoperative follow-up of march. Including 2 cases of children go to the outer court merger tracheoesophageal fistula treated stomach esophagus fistula and repairs.The rest of the children in my line of anti-infection, nasogastric recovered after the treatment, nutritional support treatment. In march, postoperative follow-up review result satisfied.Conclusion To obtain detailed medical history;As soon as possible to choose the appropriate surgical treatment;Actively carry out the multidisciplinary diagnosis and treatment, can improve the clinical success rate of esophageal foreign body in children, reduce the occurrence of complications.