食管异物197例临床特点分析

许可，邓盛，熊荣生，白韬

（广西壮族自治区南溪山医院胸心血管外科，广西 桂林，541002）

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摘要：

目的 回顾性分析197例食管异物患者的临床资料，探讨食管异物的临床特点，以提高诊治率。方法 收集2008年1月至2015年5月收治的经胸部X线、胸部CT等检查确诊的食管异物患者197例，患者均表现为吞咽困难和疼痛，观察患者年龄、异物种类、停留部位、治疗方法及并发症等指标。结果 164例患者通过硬质食管镜取出异物，10例患者通过电子胃镜取出异物，10例患者行颈侧切开取出异物，13例患者行胸部切口取出异物；1例患者术后出现严重纵膈感染衰竭死亡，1例患者术后出现主动脉食管瘘（AEF）感染出血死亡。结论 对于食管异物患者应尽早诊断，诊断一旦明确，内镜异物取出术是治疗食管异物的首选方法，同时应根据异物的所处部位采取不同的手术方式，避免并发症的发生。

关键词：食管异物；吞咽困难；主动脉食管痰

中图分类号：R768.32文献标志码：A文章编号：2096-1413(2017)06-0126-02

Analysis of clinical characteristics of 197 cases of esophageal foreign body
XU Ke, DENG Sheng, XIONG Rong-sheng, BAI Tao
(Department of Cardiovascular Thoracic Surgery, Nanxishan Hospital of Guangxi Zhuang Autonomous

 Region, Guilin 541002, China)

ABSTRACT: Objective The clinical data of 197 patients with esophageal foreign body were retrospectively analyzed, and the clinical characteristics of esophageal foreign body were assessed, in order to improve the diagnosis and treatment rate. Methods One hundred and ninety-seven cases of patients with esophageal foreign body were collected from January 2008 to May 2015, and all the patients were diagnosed by chest X-ray and chest CT, all the patients presented with dysphagia and pain, the indexs of patients' age, type of foreign body, location of foreign body, the treatment methods and complications were observed. Results One hundred and sixty -four cases of foreign bodies were taken out by rigid endoscope, 10 cases of foreign bodies were taken out by electronic gastroscope, 10 cases of foreign bodies were taken out by lateral neck incision, 13 cases of foreign bodies were taken out by thoracic incision, 1 case of patient died of severe diaphragm infection, 1 case of patient died of infection and bleeding after aortic esophageal fistula (AEF) repair. Conclusion Esophageal foreign body should be diagnosed as soon as possible; once diagnosed, endoscopic removal of foreign bodies is the first choice for the treatment of esophageal foreign body; at the same time, different surgical methods should be taken according to the location of the foreign body. The occurrence of complications should be avoided.
KEYWORDS: esophageal foreign body; dysphagia; aortic esophageal fistula

参考文献：
[1] 金斌,董频,张佳.食管穿孔的诊疗及其结果分析[J].中国耳鼻咽喉头颈外科,2006,13(3):193-195.
[2] 蒋勇,林凌,张建卫,等.食管异物的合理化诊治[J].中华胸部外科电子杂志,2015,2(1):55-62.
[3] ALRAZZAK BA,AL-SUBU A,ELITSUR Y.Etiology and management of esophageal impaction in children: a review of 11 years[J].Avicenna J Med,2013,3(2):33-36.
[4] 黄选兆,汪吉宝,孔维佳.实用耳鼻咽喉头颈外科学[M].北京:人民卫生出版社,2011:574-576.
[5] ORJI FT,AKPEH JO,OKOLUGBO NE.Management of esophageal foreign bodies : experience in a developing country [J].World J Surg, 2012,36(5):1083-1088.
[6] WU WT,CHIU CT,KUO CJ,et al.Endoscopic management of suspected esophageal foreign body in adults[J].DisEsophagus,2011,24(3):131-137.
[7] 刘靖正,周平红,姚礼庆,等.上消化道异物714例胃镜治疗体会[J]. 中华消化内镜杂志,2012,23(1):46-47.
[8] JACKSON CL.Foreign bodies in the esophagus[J].Am J Surg,1957,93 (2):308-312.
[9] VIZCARRONDO FJ,BRADY PG,NORD HJ.Foreign bodies of the upper gastrointestinaltract[J].Gastrointest Endosc,1983,29(3):208-210.
[10] WEBB WA.Management of foreign bodies of the upper gastrointestinal tract: update[J].Gastrointest Endosc,1995,41(1):39-51.
[11] 章毅,王敏,古艳,等.301例食管异物患者临床诊治分析[J].中国耳 鼻咽喉颅底外科,2013,19(4):322-324.
[12] 杨光煜,何苡,胡为才,等.13例食管异物穿孔并严重纵隔感染[J]. 中华胸心血管外科杂志,2014,30(4):250-251.
[13] 毛弈韬,聂智樱,杨福伟,等.食管异物引起严重并发症的临床分析 [J].临床耳鼻咽喉头颈外科杂志,2012,26(24):1111-1112.