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目的研究儿童上消化道异物的临床和内镜特点,总结其处理经验。方法 2001年9月-2009年6月在本院因可疑消化道异物就诊的患儿257例,患儿就诊24h内行Olympus胃镜检查,发现异物后选择合适异物钳进行钳取。结果 257例患儿内镜检查发现消化道异物256例,异物种类较多,硬币82例、各类果核49例、金属别针37例、纽扣电池23例、发卡19例、塑料口哨12例、圆珠笔帽9例,不铁钉8例、规则硬质塑料玩具碎片7例、塑料长棒(6～10cm)5例、金耳环3例、气管插管2例。异物主要分布于食管、胃及十二指肠。有相关上消化道疾病23例,包括贲门失驰缓症11例、幽门溃疡5例、胃轻瘫4例、食管狭窄3例。消化道异物的钳取使用多种异物钳,其中鳄口钳、网篮和三爪钳最常用。消化道异物钳取的成功率为99.2%。结论胃镜钳取用于消化道异物具有成功率高、安全性高、并发症少等优点。内镜检查是诊断和治疗消化道异物的有效方法 。
Objective To study the clinical and endoscopic features of children with upper gastrointestinal tract foreign body and to summarize their treatment experience. Methods From September 2001 to June 2009, 257 children were admitted to our hospital due to suspected gastrointestinal foreign bodies. Olympus gastroscopy was performed on the patients within 24 hours of treatment. After the foreign body was found, foreign body forceps were selected for forceps extraction. Results 257 cases of endoscopic examination in children found that 256 cases of foreign body of digestive tract, foreign body more types, coins 82 cases, 49 cases of various types of fruit nucleus, 37 cases of metal pins, button batteries in 23 cases, 19 cards, plastic whistles in 12 cases, There were 9 cases of ballpoint pen caps, 8 cases of no nail, 7 cases of rigid plastic toy fragments, 5 cases of plastic rods (6 ~ 10cm), 3 cases of gold earrings and 2 cases of tracheal intubation. Foreign body mainly in the esophagus, stomach and duodenum. There are 23 cases of upper gastrointestinal diseases, including 11 cases of cardia dementia, 5 cases of pyloric ulcer, 4 cases of gastroparesis, 3 cases of esophageal stricture. Foreign body pliers use a variety of foreign body forceps clamp, which alligator pliers, baskets and the three jaws most commonly used. Gastrointestinal foreign body forceps with a success rate of 99.2%. Conclusion Endoscopic forceps for gastrointestinal foreign body has the advantages of high success rate, high safety, fewer complications. Endoscopy is an effective method to diagnose and treat digestive tract foreign body.