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find Keyword "食管异物" 13 results
  • Surgical Management of Esophageal Foreign Bodies

    Objective To investigate the effect of surgical treatment of patients with esophageal foreign bodies (EFBs), in order to provide a reference for its prevention. Methods We retrospectively analyzed the clinical records of 18 patients with EFBs treated in West China Hospital from June 2005 to December 2010. There were 13 males and 5 females with an average age of 57.50±15.28 years (30 to 82 years). All the 18 patients had a history of ingesting EFBs which were mainly animal bones (10/18). The EFBs were mostly in the upper segments of the esophagus (12/18). Sixteen patients had complications like perforations and severe mucosal injuries, while complications were not detected in the other 2 patients. Fifteen patients received surgical treatment, while the other 3 patients didn’t. Results As for the 15 patients with surgical treatment, the operative time was 136.33±92.86 minutes (50 to 410 minutes), and the hospital stay was 16.35±15.8 days (4.00 to 69.92 days). Three patients (of which,one aged at 78 years and one 82 years) died, among whom two died of multiorgan failure, and 1 died of respiratory failure. All the other 12 patients were discharged from the hospital. For the 3 patients without surgical treatment, the hospital stay time was 5.06±1.47 days ranged from 3.71 to 6.63 days. They were cured and left the hospital. Conclusion EFBs should be treated as early as possible to reduce severe complications. Surgery is still one of the mostly used treatments for EFBs. Senility and complications are the major causes of death. It should be comprehensively assessed whether the EFBs patients should receive operations and which operative procedures should be performed.

    Release date:2016-08-30 05:57 Export PDF Favorites Scan
  • 外科手术取食管异物15例

    目的探讨外科手术取食管异物的适应证及手术方法。方法采用外科手术摘除尖锐食管异物15例,其中颈段5例,胸段10例。5例颈段异物均合并脓肿,行脓肿切开引流同时取出异物;4例胸段异物摘除后施行改良食管腔内置管术;余6例取出异物后分层缝合食管切口。结果全组无死亡。4例施行食管腔内置管,术后1~2周中毒症状缓解,3~5周拔管后食管X线钡餐造影检查无穿孔或狭窄。1例切开食管取异物后发生右侧脓胸,术后第8d行脓胸廓清术及改良食管腔内置管,1个月后治愈;其余患者术后7~10d恢复经口进食。结论已穿透食管的金属异物和食管镜摘除易引起穿孔的尖锐异物应采用外科手术治疗,改良食管腔内置管对纵隔感染严重、无法修补的穿孔愈合是有帮助的。

    Release date:2016-08-30 06:22 Export PDF Favorites Scan
  • Clinical Analysis on 138 Cases of Removing Esophageal Foreign Bodies in Children by Utilizing Foley Catheter

    Objective To discuss the safety and effectiveness of removing esophageal foreign bodies in children by using Foley catheter. Method Retrospective analysis on the effect, operation method, complication and the types of foreign bodies of 138 cases of removing esophageal foreign bodies in children by using Foley catheter, which happened from January 1998 to January 2008 in Department of Otorhinolaryngology, the Third People’s Hospital of Chengdu. Result Among these 138 cases with esophageal foreign bodies, 126 cases (91.3%) were successfully taken out by using Foley catheter without anaesthesia, 7 cases were applied esophagoscopy under general anaesthesia, and 5 cases were cured owing to the slipping of foreign body into stomach. The operating time for Foley catheter was 5.1 minutes in average, and there’s no complicating disease in any case. The hard esophagoscope operation lasted for 15 minutes in average and one case was accompanied by dyspnea. The foreign bodies in 138 cases were coin (98 cases), button (14 cases), chess and I-go piece (13 cases), key-ring (4 cases), plastic bottle cap (3 cases), oblate battery (3 cases) and ring (3 cases), respectively. Conclusion Foley catheter is safe and effective for removing esophageal obtuse-rounded foreign bodies in children.

    Release date:2016-09-07 11:24 Export PDF Favorites Scan
  • 食管异物伴穿孔感染后胃镜下取出并置入空肠营养管的围手术期护理一例

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  • Clinical Application of Lateral Neck Incision in the Removal of Incarcerated Esophageal Foreign Body

    ObjectiveTo discuss the indication and vital procedure of lateral neck incision applied for the removal of relatively big esophageal incarcerated foreign body, in order to improve the level of diagnosis and treatment of esophageal foreign body. MethodsThe clinical data of 23 patients suffering from esophageal incarcerated foreign body and treated between May 2009 and May 2012 were retrospectively analyzed. Time of onset, foreign body type and shape, and operation method were studied. ResultsAll 23 patients recovered successfully and were discharged from the hospital within 1 week, without severe complications like esophageal perforation or esophageal peripheral inflammation. ConclusionFor esophageal superior segment big incarcerated foreign body, lateral neck incision can expand the visual field, reduce operation blind area, avoid irregular injury of the esophageal wall and occurrence of complications.

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  • 食管异物及合并主动脉食管瘘的诊断与治疗

    目的探讨食管异物所致主动脉食管瘘的诊断及治疗方法。 方法回顾性分析2004年1月至2012年12月南昌大学第二附属医院32例异物性食管损伤患者的诊断和治疗经验。其中男21例、女11例,年龄18~78岁。采用多层螺旋CT(MSCT)及其影像后处理对食管异物病理变化进行准确分级;对主动脉食管瘘的患者采用包括杂交技术(覆膜支架腔内隔绝术+胸腔镜纵隔引流术)为主的治疗方案,总结MSCT和杂交技术在异物性主动脉食管瘘诊疗中的应用价值。 结果平扫影像诊断与临床诊断符合率为75%(24/32),影像后处理诊断与临床诊断符合率为100%(17/17)。MSCT分级所有Ⅰ级、Ⅱ级和Ⅲ级患者均治愈出院,4例Ⅳ级患者采用杂交技术治疗;7例Ⅳ级主动脉食管瘘患者中有5例痊愈出院,2例死亡,因开胸行主动脉修补术中死亡1例,开胸行主动脉置换术后24 h内死亡1例。30例痊愈出院患者随访6个月,除1例Ⅳ级患者有轻微背痛以外,其他患者无不适。 结论MSCT对食管异物性损伤的准确分级和治疗方式选择均有重要的价值,杂交技术治疗异物性主动脉食管瘘具有重要的临床意义。

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  • 手术成功救治食管主动脉瘘一例

    Release date:2016-10-02 04:56 Export PDF Favorites Scan
  • 外科途径治疗经保守处理无效的食管异物

    目的 探讨保守治疗无效的食管异物经外科治疗的手术途径和方法,以减少手术对患者的损伤和术后并发症的发生、促进患者快速康复。 方法 回顾性分析 2011 年 6 月至 2016 年 8 月我院食管异物经保守治疗无效需外科手术治疗 37 例患者的临床资料,其中男 21 例、女 16 例,年龄 17~62(42.00±9.75)岁。8 例经颈部切口手术治疗,27 例经胸部切口取出异物,2 例经胸腔镜取出异物。 结果 随访 3~18(7.95±3.41)个月,4 例术后发生消化瘘患者在术后 2~5 个月能正常进食,其余患者均在术后 1 个月能正常进软质饮食,术后 1.5 个月正常饮食。2 例手术患者因术后纵隔感染、胸腔感染致脓毒血症,多器官功能衰竭死亡。 结论 食管异物的外科手术根据其嵌顿的位置不同、穿孔与否、手术路径及方法亦有所不同,采取适宜的手术途径和方法可以提高手术的准确性,减少手术对食管的损伤和术后并发症,减轻患者的痛苦,从而提高患者术后生存质量。

    Release date:2018-06-01 07:11 Export PDF Favorites Scan
  • Diagnosis and treatment of adult esophageal foreign body ingestion

    Foreign body ingestion is common in emergency. The vast majority of foreign body ingestion occurs in the pediatric population as well as mentally impaired and edentulous adults. The typical clinical manifestation of foreign body ingestion includes acute onset of dysphagia and chest pain. Most of the ingested foreign bodies pass without the need of intervention; however, about 20% of esophageal foreign body ingestion requires endoscopic removal. While less than 1% will need surgery for foreign body extraction. Timely diagnosis and proper treatment are associated with low mortality and morbidity rate, while delayed diagnosis and improper treatment always lead to severe complications such as esophageal perforation and death. This article reviews the diagnosis and treatment of adult esophageal foreign body ingestion.

    Release date:2019-03-29 01:35 Export PDF Favorites Scan
  • A comparison of clinical effects of removing foreign bodies from esophagus by rigid esophagoscope and flexible esophagoscope

    ObjectiveTo collect the data of esophageal foreign body patients, and to evaluate the clinical effects of two different surgical methods in our hospital.MethodsThe clinical data of 294 patients who were treated in Gansu Provincal Hospital from January 2012 to June 2018 were analyzed retrospectively. The clinical data were collected and analyzed by SPSS 22.0. In order to to evaluate the efficacy of flexible esophagoscope (FE) and rigid esophagoscope (RE) in the treatment of esophageal foreign bodies.The patients were divided into two groups: a RE group including 118 patients with 62 males and 56 females at age of 6 (3-37) years and a FE group including 176 patients with 84 males and 92 females at age of 6 (3-59) years.ResultsThere was no significant difference in age, age stratification, gender and foreign body type between the two groups. There was a statistical difference in the initial clinical symptoms (P=0.041) or in esophageal foreign bodies position (P=0.037) between the two groups. The success rate of foreign body removal was similar between the two groups (P=0.632). The success rate was 88.9% (105/118) in the RE group, 87.5% (154/176) in the FE group. The operation time was significantly longer in the RE group than that in the FE group (10.8 ±17.4 min vs. 17.5±21.6 min, P<0.001). The postoperative hospitalization time in the RE groups was longer than that in the FE group (21.5 ±24.2 hours vs. 12.5 ±21.3 hours, P<0.05). There was a statistical difference in the incidence of postoperative complications between the two groups (P=0.034). In the RE group, the main complication was mucosal edema (15.3%). And the rate of bleeding was higher (15.9%) in the FE group. There were 30 patients (25.5%) in the RE group with minor postoperative complications versus the FE group with 40 patients (22.7%); and 1 patient (0.8%) in the RE group with severe complications versus the FE group with 5 paients (2.8%).ConclusionBased on the analysis of this study, it is found that RE has higher safety. But the indications are strict, the professional requirements of the operator and the selection of patients are stronger. The FE is convenient to use, the operation crowd is wide, and the suitable crowd is wide. Therefore, for specific patients, after improving the relevant examination and preoperative evaluation of patients, clinicians need to choose appropriate surgical methods to ensure the success of the operation, and reduce the postoperative complications as far as possible.

    Release date:2019-12-13 03:50 Export PDF Favorites Scan
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