小儿磁性消化道异物手术治疗5例

Surgery treatment of pediatric magnetic gastrointestinal foreign body: a report of 5 cases

近年来,随着巴克球玩具越来越多,小儿误食巴克球导致消化道异物病例占比逐渐升高。巴克球的强磁性可导致胃肠道受压缺血、坏死、穿孔,肠瘘继发肠粘连,可危及生命。患儿发病时间、误吞数量、方式、就诊时间差异明显,且早期症状不典型,临床报道及治疗经验不多。对此类病例的手术治疗逐渐形成共识。治疗的个体化需求明显,需从患儿年龄、吞入方式、磁性消化道异物数量、部位、时间、腹部症状等综合考量,决定手术探查时机。手术可采用腹腔镜或常规剖腹手术方式。需探查全部消化道,视腹腔情况决定行单纯修补、部分肠切除吻合或松解粘连等。小儿磁性消化道异物的预防,需广泛社会宣传,提高家长及相关机构对磁性玩具危害的认识,避免延误治疗时机导致严重后果。控制接触此类玩具儿童的年龄,从源头上减少此类疾病发生。

In recent years,with increasing number Buck ball toys,the proportion of children who swallow Buck ball by mistake has gradually increased.The strong magnetism of Buck’s ball can lead to gastrointestinal compression,ischemia,necrosis,perforation.Intestinal fistula secondary to intestinal adhesion can be life-threatening.The differences of time of onset,number of swallows,methods and the time of treatment are significantly different.Early symptoms are atypical.Clinical reports and treatment experience are few.There is a consensus on the surgical treatment of such cases.Treatment needs to be individualized.The time of surgical exploration should be determined according to children’s age,way of swallow,the number,location,time of magnetic gastrointestinal foreign body,abdominal symptoms,and other comprehensive conditions.Laparoscopic or conventional laparotomy can be used.All digestive tract should be explored.Simple repair,partial intestinal resection anastomosis or adhesion release can be performed depending on the abdominal cavity.The prevention of magnetic foreign bodies swallowed by children needs extensive social publicity to improve awareness of parents and relevant institutions on the danger of magnetic toys,so as to avoid serious consequences caused by delayed treatment.At the same time,measures need to be taken to control the age of children exposed to such toys,and reduce the occurrence of such cases from original source.