内镜治疗对消化道异物患者的安全性与可行性分析

Safety and feasibility of endoscopic treatment for patients with foreign bodies in digestive tracts

目的探讨内镜治疗对消化道异物患者的安全性与可行性。方法回顾性分析2019年10月10日至2023年8月20日南昌大学第一附属医院高新医院消化内科接受内镜治疗的77例消化道异物患者资料。其中男性41例,女性36例,年龄2~91(46.40±27.03)岁,其中上消化道异物75例(97.4%),下消化道异物2例(2.6%)。结果77例患者中,上消化道异物以梗阻在食管上段为主[58.4%(45/77)],异物种类以鱼(骨)刺[32.4%(25/77)]和其他动物骨为主[20.8%(16/77)],异物形状以尖锐异物为主[51.9%(40/77)]。内镜下消化道异物一次性成功取出率100%(77/77),内镜下异物取出总并发症发生率为57.1%(44/77)。其中,轻微并发症占81.8%(36/44)、消化道穿孔占9.1%(4/44)、创面破损伴感染占6.8%(3/44)、活动性出血占2.3%(1/44)。结论内镜治疗是消化道异物治疗的首选方法,尽早取出异物,可减少异物相关并发症,且内镜下治疗消化道异物是安全、有效的。

Objective To explore the safety and feasibility of endoscopic treatment for patients with foreign bodies in digestive tracts.Methods The data of 77 patients with foreign bodies in digestive tracts treated by endoscopy in Department of Gastroenterology,Gaoxin Branch of The First Affiliated Hospital,Jiangxi Medical College,Nanchang University from October 10,2019 to August 20,2023 were retrospectively analyzed.There were 41 males and 36 females.They were 2-91(46.40±27.03)years old.Seventy-five patients(97.4%)had foreign bodies in the upper digestive tracts,and 2(2.6%)the lower digestive tracts.Results Among the 77 patients,45 cases(58.4%)had foreign bodies in the upper esophageal segments.The main foreign bodies were fish bones[32.4%(25/77)]and other animals'bones[20.8%(16/77)].Most foreign bodies were sharp,with a proportion up to 51.9%(40/77).The one-time successful removal rate of foreign bodies was 100.0%(77/77).The total incidence of complications in endoscopic foreign body removal was 57.1%(44/7,),including 36 cases of mild complications[81.8%(36/44)],4 cases of gastrointestinal perforation[9.1%(4/44)],3 cases of wound damage with infection[6.8%(3/44)],and 1 case of active bleeding[2.3%(1/44)].Conclusions Endoscopic treatment is the first choice for the treatment of foreign bodies in the digestive tracts.Foreign bodies should be removed as soon as possible to reduce complications related to foreign bodies.Endoscopic treatment of foreign bodies in digestive tracts is safe and effective.