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1、中国胸心血管外科临床杂志2011年8月第18卷第4期ChinJClinThoracCardiovascSurg,August2011,Vol.18,No.4#329#论著#临床研究食管异物的外科治疗时辉沈春辉梅龙勇周渝斌车国卫(四川大学华西医院胸外科,成都610041)摘要:目的探讨食管异物患者外科治疗的效果,为其防治提供借鉴。方法回顾性分析华西医院2005年6月至2010年12月收治的18例食管异物患者的临床资料,其中男13例(72.22%),女5例(27.78%);年龄57.50?15.28岁(30~82岁)。18例患者均有吞食异物史,食
2、管异物以动物骨骼为主(55.55%,10/18),食管胸上段(66167%,12/18)为异物最常见嵌顿部位。2例未检查出确切并发症,16例有不同程度的穿孔、黏膜重度损伤等并发症。15例行手术治疗,3例未行手术治疗。结果15例行手术治疗患者的手术时间136.33?92.86min(50~410min),住院时间16.35?15.80d(4.00~69.92d);3例(其中78岁和82岁各1例)死亡,2例死于多器官功能衰竭,1例死于呼吸衰竭;其余12例顺利出院。3例未手术患者的住院时间为5.06?1.47d(3.71~6163d),均治愈出院。
3、结论食管异物患者应及早就诊以减少相关并发症,手术为主要治疗方法之一。高龄和并发症是手术治疗死亡的主要原因。应在全面评估患者情况的基础上决定是否手术,选择术式。关键词:食管异物;外科治疗;并发症中图分类号:R655.4文献标识码:A文章编号:1007-4848(2011)04-0329-03SurgicalManagementofEsophagealForeignBodiesSHIHui,SHENChun-hui,MEILong-yong,ZHOUYu-bin,CHEGuo-wei.(DepartmentofThoracicSurgery,We
4、stChinaHospital,SichuanUniversity,Chengdu610041,P.R.China)Correspondingauthor:CHEGuo-wei,Email:cheguowei@yahoo.com.cnAbstract:ObjectiveToinvestigatetheeffectofsurgicaltreatmentofpatientswithesophagealforeignbodies(EFBs),inordertoprovideareferenceforitsprevention.MethodsWere
5、trospectivelyanalyzedtheclinicalrecordsof18patientswithEFBstreatedinWestChinaHospitalfromJune2005toDecember2010.Therewere13malesand5femaleswithanaverageageof57.50?15.28years(30to82years).Allthe18patientshadahistoryofingestingEFBswhichweremainlyanimalbones(10/18).TheEFBswere
6、mostlyintheuppersegmentsoftheesophagus(12/18).Sixteenpatientshadcomplicationslikeperforationsandseveremucosalinjuries,whilecomplicationswerenotdetectedintheother2patients.Fifteenpatientsreceivedsurgicaltreatment,whiletheother3patientsdidn.t.ResultsAsforthe15patientswithsurg
7、icaltreatment,theoperativetimewas136.33?92.86minutes(50to410minutes),andthehospitalstaywas16.35?15.8days(4.00to69.92days).Threepatients(ofwhich,oneagedat78yearsandone82years)died,amongwhomtwodiedofmult-iorganfailure,and1diedofrespiratoryfailure.Alltheother12patientsweredisc
8、hargedfromthehospital.Forthe3patientswithoutsurgicaltreatment,thehospitalstaytimew
