小儿消化道磁性异物13例临床分析并文献复习

Clinical analysis of 13 cases of magnetic foreign bodies in the digestive tract of children and literature review

目的总结消化道磁性异物临床特点及胃镜下异物取出时机,帮助早期诊治及改善预后。方法回顾性分析本院2016年1月1日至2020年6月1日收治的13例摄入磁性异物患儿的临床资料并复习相关文献。结果13例磁性异物患儿,男11例,女2例,男女比例为5.5∶1;年龄范围为2~12岁,好发于6岁以上儿童[(61.5%(8/13)];摄入至就诊时间最短1 h,最长30 d;主要临床症状为腹痛、呕吐;胃穿孔2例,肠穿孔4例,合并肠梗阻2例、肠套叠1例;自行排出4例,经胃镜取出4例,外科手术5例。结论消化道磁性异物高发于6岁以上儿童,应加强此阶段患儿的监管及教育;临床症状轻微、不典型,2个以上不易排出;若出现消化道症状、穿孔等并发症概率大,应紧急处理;内镜处理可减少患儿的手术创伤、住院时间及医疗花费。

Objective To summarize the clinical characteristics of magnetic foreign bodies in the digestive tract and the timing of extracting foreign bodies by gastroscopy to help early diagnosis and treatment and improve the prognosis.Methods The clinical data of 13 children with magnetic foreign bodies admitted to our hospital from January 1,2016 to June 1,2020 were retrospectively analyzed,and the related literatures were reviewed.Results A total of 13 children(11 males and 2 females,the male-to-female ratio was 5.5:1)with magnetic foreign bodies were enrolled in the study.The age range was 2-12 years old,and it was more common in children over 6 years old[61.5%(8/13)].The range of time between intake and treatment was 1 hour-30 days.The main clinical symptoms of these children were abdominal pain and vomiting.Among them,there were 2 cases of gastric perforation,4 cases of intestinal perforation,2 cases of intestinal obstruction,and 1 case of intussusception.In terms of treatment,the magnetic foreign bodies were discharged spontaneously in 4 cases,extracted by gastroscopy in 4 cases,and removed by surgery in 5 cases.Conclusions The incidence of magnetic foreign bodies in the digestive tract is high in children over 6 years old,so the supervision and education on children during the age period should be strengthened.Children who have mistakenly swallowed more than two magnetic foreign bodies have mild and atypical clinical symptoms,and the foreign bodies are not easy to discharge.However,once these children have high risk of complications such as gastrointestinal symptoms and perforation,emergency treatment should be taken.Endoscopic treatment can reduce the surgical trauma,hospital stay,and medical cost.