儿童胃石症9例诊治经验

Management Experience of Gastrolithiasis in Children:A Report of 9 Cases

目的总结儿童胃石症的临床特点及治疗经验。方法回顾性分析郑州大学第一附属医院2009年6月至2020年6月收治的9例胃石症患儿临床资料。结果9例胃石症患儿均为女性,年龄为4~13岁,其中8例有异食癖,1例发病前曾大量进食柿子。7例经内镜检查确诊,1例经CT确诊,1例经消化道造影确诊。4例经内镜取石治疗,5例经外科手术治疗,最终8例确诊为毛发性胃石症,1例为植物性胃石症。随访1~2 a,9例患儿均恢复良好,胃石症未复发,贫血及营养不良状况均有不同程度改善。结论儿童胃石症常见于女童,多伴有异食癖,一经诊断应及时治疗,首选内镜取石,内镜取出失败可考虑外科手术治疗,治疗效果及患儿预后好。

Objective To summarize the clinical characteristics and treatment experience of children with gastrolithiasis.Methods The clinical data of 9 children with gastrolithiasis admitted to the First Affiliated Hospital of Zhengzhou University from June 2009 to June 2020 were retrospectively analyzed.Results The 9 children with gastrolithiasis were all female,aged 4-13 years.Eight of them had pica,and one had eaten a lot of persimmons before the onset.Seven cases were confirmed by endoscopy,one case was confirmed by CT,and one case was confirmed by gastrointestinal angiography.Four cases were successfully treated by endoscopic lithotripsy,and five cases were treated by surgery.There were eight cases of hairy gastrolith and one case of plant gastrolith.After a follow-up of one to two years,all nine children recovered well,none of them had recurrence of gastrolithiasis,and their anemia and malnutrition were improved to varying degrees.Conclusion Children’s gastrolithiasis is common in girls and is often accompanied by pica.Once diagnosed,it should be treated promptly.Digestive endoscopy is the first choice for stone removal.If endoscopic treatment fails,surgical treatment can be considered.The treatment effect and the prognosis are good.