急诊胃镜在儿童上消化道异物中的诊疗体会.docVIP

急诊胃镜在儿童上消化道异物中的诊疗体会 （1江苏省第二中医院外科 江苏南京210000） （2南京医科大学第二附属医院儿童消化内镜中心江苏南京210000） 目的探讨急诊胃镜治疗儿童上消化道异物的方法、安全性及疗效 和经验。方法回顾性分析2008?2015年在我院就诊的儿童上消化道异物患者 46例，在氯胺酮、丙泊酚全身麻醉下行急诊胃镜下消化道异物取出术，术前常 规摄片定位。根据异物的种类、形态，选择鼠齿钳、网篮等不同种类器械予以取 出。术后留院观察两日有无并发症发牛，同时依据异物有无造成黏膜损伤而使用 抑酸药物1?2日。结果46例异物儿童中势孩35例，女孩口例；年龄6月? 8岁,其中lt;l岁的5例，1?3岁的30例，3?7岁的8例，gt;7岁的3例； 误吞时间为3h?6d； 46名异物患儿上消化道异物共46个；46例异物中硬币异 物共39例，电池3例，笔帽1例，枣核1例，回形针1例，戒指1例。异物嵌 入部位食管上端41例，胃内5例。内镜下异物成功取出45例，1例由于异物（枣 核）己刺破黏膜而转入外科手术治疗，成功率为97.8%；内镜下异物取出成功病 例患儿术后均未发生出血、穿孔等并发症。结论急诊胃镜下治疗儿童上消化道 异物的首选方法，具有简便、安全、有效特点。家长在日常护理中避免儿童将异 物特别是硬币放入嘴里，可明显降低儿童的上消化道异物的发牛率。 关键词 消化道异物；急诊内镜；儿童 R445 A 1007-8231 （2016） 15-0030-02 Emergency Gastroscopy in Diagnosis and Treatment of Foreign Bodies in Childrenrsquo;s Digestive Tract Jiang bailianl’Sheng weisong2,Zhu danrong2. IThe Second Traditional Chinese Medicine Hospital of Jiangsu provinee, Anorectal Surgery,Nanjing,210000.2The Second Affiliated Hospital of Nanjing Medical University, Childrens Digestive Endoscopy Center, Nanjing,210000 Abstract] Objective To study the methods, safety, effects and experience of emergency gastroscopy in treating foreign bodies in Childrenrsquo;s digestive tract. Method Retrospective analysis from 2008 to 2015, 46 children with foreign bodies in digestive tract went to see doctor in our hospital. The foreign bodies were taken out by using emergency gastrospocy after general anesthesia with katamin and propofol, using radiographic localization before operation. Choose different tools as rat-tooth forceps or basket according to foreign bodiesrsquo; types and forms. After the operation the patients remained for two days for complication observation. Meantime, use acid suppress!on medicines for 1 or 2 days in view of the fact that whether the foreign body caused mucosal damage or not.Result Among 46 patients, 35 boys and 11 girls. Age: 6 months?8 years old. Among them, 5 patients lt; 1 year old, 30 patients between 1?3 years old, 8 patients between 3?7 years old, 3 patient