儿童纽扣电池食道异物临床诊疗分析

Analysis of diagnosis and treatment of esophageal foreign body caused by button battery in children

目的通过分析我院纽扣电池食道异物患儿的诊断、治疗、转归,为儿童纽扣电池食道异物临床诊治提供依据。方法回顾性分析我院2016年8月至2021年8月收治的20名纽扣电池食道异物患儿的临床资料、诊治经过及转归,列举典型病例;结果20例纽扣电池食道异物患儿,年龄10月-7岁,均在全麻下硬性食道镜取出纽扣电池,术后留置胃管或空肠管7天至1年。随访1年:死亡2例(大出血致死亡),气管食管瘘2例,治愈16例。结论及早发现、尽快取出异物是儿童纽扣电池食道异物治疗的关键,提高医务人员对纽扣电池食道异物危害性的认识是及时诊断的举措之一。术后需根据食道损伤程度选择不同的胃肠减压管,掌握拔除胃肠减压管的时机,加强术后护理,是积极防治并发症的重要措施。

Objective To provide evidence for the clinical diagnosis and treatment of button battery esophageal foreign body in children by analyzing the diagnosis,treatment and outcome of button battery esophageal foreign body in our hospital.Methods The clinical data,diagnosis,treatment and outcome of 20 children with button battery esophageal foreign body admitted to our hospital from August 2016 to August 2021 were retrospectively analyzed,and typical cases were listed.Results 20 children with button battery esophageal foreign body,aged from 10 months to 7 years,were removed by rigid esophagoscope under general anesthesia,and were given gastric tube or jejunal tube for 7 days to 1 year after operation.After 1 year follow-up,2 cases died(caused by massive bleeding),2 cases of tracheoesophageal fistula,and 16 cases were cured.Conclusion Early detection and removal of foreign bodies is the key to the treatment of button battery esophageal foreign bodies in children.Improving medical staff’s awareness of the harm of button battery esophageal foreign bodies is one of the measures for timely diagnosis.Different gastrointestinal decompression tubes should be selected according to the degree of esophageal injury after operation,the timing of removing gastrointestinal decompression tubes should be mastered,and postoperative nursing should be strengthened,which are important measures to actively prevent and treat complications.