儿童食道硬币类异物的临床特征

Features of esophageal coins in the pediatric population

目的 食道硬币类异物为儿童最常见急诊,其脱落率、手术时机等特征尚不统一。文章主要探讨儿童食道硬币类异物的特征,为临床工作提供帮助。方法 收集南京儿童医院自2018年2月到2021年7月门急诊以及病房的522例食道硬币类异物患儿。分析患儿的性别、年龄、硬币异物发病时间、发病趋势、硬币大小和患儿年龄关系以及食道硬币类异物自发脱落的因素。结果 1~4岁儿童较易发生食道异物;食道异物发病率在春夏季较高为35%,秋冬季较低为16%,并且随着患儿年龄的增加而减低,且年发病率有逐渐减低的趋势;小的硬币异物多见于年幼儿童[(32.15±1.20)个月],较大的硬币见于年长儿童[(60.42±1.14)个月]。患儿性别和年龄与食道硬币脱落率无关;儿童食道硬币脱落率与硬币大小、嵌顿时间及位置有关。结论 儿童食道硬币异物与年龄、季节相关,近年来随着电子支付的流行发病率也在逐年降低。硬币大小、嵌顿时间以及位置可能影响硬币的脱落率。

Objective Esophageal coins are the most common emergency in the pediatric population, but its detachment rate, operation timing and other features are various. This article mainly discusses the characteristics of children′s esophagus coins, in order to provide help for clinical work. Methods A total of 522 pediatric cases with esophageal coins from Feb 2018 to July 2021 were included in the study. Analysis has been performed on the patients′ gender, age, time of onset, incidence trend, the relations between the size of esophageal coins and the patient′s age, and the factors affecting spontaneous falling of esophageal coins. Results Children aged 1-4 are more prone to esophageal foreign bodies. The incidence of esophageal foreign bodies is as high as 35% in spring and summer, and as low as 16% in autumn and winter. The incidence of foreign bodies in the esophagus is indicated to decrease with the increase of children′s age, and the annual incidence shows a decreasing trend. Small esophageal coins are more common in young children [(32.15±1.20) months], while larger coins are commonly seen in older children [(60.42±1.14) months]. Gender and age are not correlated with esophageal coin-falling rate. The esophageal coin-falling rate in children is correlated to coin size, immobilization time and its location. Conclusion Children′s esophagus coins are more common in children aged 1-4. The incidence is highest in summer, and the annual incidence gradually decreases. Small esophagus coins are more common in young children, while large coins are more common in older children. Coin size, immobilization time, and location may affect its characteristics such as coin-falling rate.