七年制医学课件耳鼻喉7食管异物.ppt

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1、ForeignBodyintheEsophagus食管异物重庆医科大学附属第一医院耳鼻喉科陈鸿雁1、Anatomy4physiologicalnarrows(4个生理性狭窄)Theentranceoftheesophagus（食道入口）Abouttheleverof4ththoraticvertebra(第4胸椎)Abouttheleverof5ththoraticvertebra(第5胸椎)Abouttheleverof10ththoraticvertebra(第10胸椎)2、Etiology(病因学)(1)Commoninchildrenandtheelders（老人和

2、儿童常见）(2)Diseasesoftheesophogusitself（食道本身病变）(3)Foreignbodymostlylocatedinthefirstnarrow（第一狭窄常见）(4)Animalforeignbodiesareoftenfound（动物性异物常见）Entranceofesophagus（食道入口）3、ClinicalAppearance（临床表现）(1)Dysphagia(吞咽困难)(2)Dynphagiaorodynophagia(吞咽疼痛)(3)Symptomsofrespiratorysystem(呼吸道症状)Dyspnea(呼吸困难)A

3、pnea（窒息）(4)limittedactivityoftheneck颈部活动受限(5)highfever发热(6)inflammationofesophagus食道穿破感染4、Diagnosis(诊断)(1)Thehistoryofswallowsth.(误吞异物史)(2)Clinicalsymptoms(临床症状)(3)PE（physicalexamination）（体格检查）(4)X-ray:A、Metallicforeignbodies（金属异物）-----easilyB、fishbone.meat(duckchicken)bone（动物骨肉）-------dif

4、ficultawispofbariumcottonmaybehelpful（钡棉透视）(5)Esophagoscopy（食管镜检查）ToexaminetheesophagusTotakeouttheforeignbodiesTheupperrimofthecoinisjustvisibleinthepostcricoidregionForeignbody,toykey,incervicalesophagusForeignbody,cervicalesophagus5、Complication（并发症）(1)Perforationorinflamationoftheesoph

5、agus(食管穿孔或食道炎症)(2)AerodermectasiaorPneumohypoderma（皮下气肿）(3)Periesophagitisormediastinitis(食管周围炎或纵隔炎)(4)Breaking-outofgreatbloodvessel(血管破溃)(5)Tracheo-esophagealfistula(气管食管瘘)6、Treatment(治疗)（1）Removaloftheforeignbody（异物取出术）usuallyrigidesophagoscopy（通常用硬管）(2)Internaltreatment（内科治疗）(3)Managem

6、entofcomplication（处理并发症）Thankyou