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目的 探讨从口而入的消化道异物特别是故意吞入的异物的影像定位和取出方法 ,以求最佳治疗效果。方法 对 1993年～ 1999年 34例上消化道异物的急诊病例 ,经耳鼻喉科检查或X线摄片后 ,确诊异物位于食道或胃内者 ,施行急诊内镜下异物取出术。经X线摄片定位 ,确诊异物位于十二指肠球部以下者 ,嘱病人次日来院复诊 ,再经X线摄片 ,观察异物的位置。对部分小而圆钝的异物 ,可自行排出不需特殊处理 ,门诊随访即可。结果 34例消化道异物病例中 ,2 9例在胃镜下用三爪钳、活检钳、网篮等器械安全取出异物。 4例在观察 1～ 2d后异物随粪便排出。 1例异物因其横卧嵌顿在食道中段 ,在全身麻醉下取出。 33例均安全地取出或排出异物 ,没有发生出血、穿孔等并发症。结论 消化道异物只要定位准确 ,取出方案合理可避免并发症发生
Objective To study the method of image localization and removal of foreign body invaded from the mouth, especially the deliberately ingested foreign matter, in order to find out the best therapeutic effect. Methods A total of 34 cases of upper gastrointestinal tract emergency cases from 1993 to 1999 were diagnosed by ENT examination or X-ray. The foreign bodies located in the esophagus or stomach were confirmed by emergency endoscopy. The X-ray positioning, foreign body is located in the duodenal area below, instruct the patient to visit the hospital the next day, and then by X-ray film to observe the location of foreign body. On the part of small and blunt foreign body, can be discharged without special treatment, out-patient follow-up can be. Results Among the 34 cases of gastrointestinal foreign bodies, 29 cases were safely removed by gastroscope using three-jaw forceps, biopsy forceps and basket. 4 cases in the observation of 1 ~ 2d after the foreign body with excretion. One case of foreign body implanted in the middle of the esophagus because of their horizontal position, removed under general anesthesia. 33 cases were safely removed or discharged foreign body, no bleeding, perforation and other complications. Conclusion As long as the accurate positioning of alimentary tract foreign body, remove the program reasonable to avoid complications