266例下咽部及食管上段异物临床特点及诊治分析

Analysis of Clinical Characteristics and Treatment of 266 Cases of Hypopharyngeal and Upper Esophageal Foreign Bodies

目的了解下咽部及食管上段异物临床特点。方法收集2019年7月-2020年2月就诊福建医科大学附属漳州市医院,并明确诊断为下咽部及食管上段异物的病例。其中咽部异物170例,食管上段异物96例。分析了解其临床特点、治疗手段及并发症情况。结果下咽部异物与食管上段异物临床表现均有明确饮食不慎或误吞史,以吞咽疼痛及异物感为最常见表现。下咽部异物经喉镜取出158例,电子胃镜取出11例,支撑喉镜下取出1例;食管异物经电子胃镜成功取出95例,外科手术取出1例。咽部异物中,细长型鱼刺占比达到91.76%(156/170),食管上段异物中,鱼刺占37.50%(36/96),骨头占36.46%(35/96)。结论下咽部异物与食管上段异物临床表现相似,均以细长型异物为主,但食管上段异物的并发症比下咽部异物发生率更高;电子胃镜可以发现喉镜漏诊的下咽部异物,并顺利取出。

Objective To compare the clinical characteristics of hypopharyngeal and upper esophageal foreign bodies.Methods To analyze the cases that attended Zhangzhou Affiliated Hospital of Fujian Medical University,from July 2019 to February 2020,with a clear diagnosis of a foreign body in the hypopharynx and upper esophagus.There were 170 cases of pharyngeal foreign body and 96 cases of upper esophageal foreign body.Results All patient with hypopharyngeal foreign body or upper esophageal foreign body had a clear history of swallowing a foreign body,swallowing pain and foreign body sensation were the most common manifestations.158 cases of foreign bodies in the hypopharynx were removed by laryngoscopy,11 cases removed by gastrointestinal endoscopy and 1 case removed by suspension laryngoscope;95 cases of foreign bodies in the esophagus were successfully removed by gastrointestinal endoscopy and 1 case by surgery.Among pharyngeal foreign bodies,elongated fishbones accounted for 91.76%(156/170),in upper esophageal foreign bodies,fish bones accounted for 37.50%(36/96)and other animal bones accounted for 36.46%(35/96).Conclusion Hypopharyngeal foreign bodies and upper esophageal foreign bodies have similar clinical manifestations,in which fish bones and other animal bones are the most common foreign bodies,the incidence of complications of foreign bodies in the upper esophagus is higher than that in the hypopharynx,and pharyngeal foreign bodies can be removed by gastrointestinal endoscopy.