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1、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生，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例异物儿童中男孩35例，女孩11例
2、；年龄6月〜8岁，其中<l岁的5例，1〜3岁的30例，3〜7岁的8例，>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H常护理中避免儿童将异物特别是硬币放入嘴里，可明显降
3、低儿童的上消化道异物的发生率。【关键词】消化道异物；急诊内镜；儿童【】R445【】A【】1007-8231（2016）15-0030-02EmergencyGastroscopyinDiagnosisandTreatmentofForeignBodiesinChildren’sDigestiveTractJiangbailianl,Shengweisong2,Zhudanrong2.ITheSecondTraditionalChineseMedicineHospitalofJiangsuprovince,AnorectalSurgery,Na
4、njing,210000.2TheSecondAffiliatedHospitalofNanjingMedicalUniversity,Children’sDigestiveEndoscopyCenter,Nanjing,210000[Abstract]ObjectiveTostudythemethods,safety,effectsandexperienceofemergencygastroscopyintreatingforeignbodiesinChildren’sdigestivetract.MethodRetrospectivean
5、alysisfrom2008to2015,46childrenwithforeignbodiesindigestivetractwenttoseedoctorinourhospital.Theforeignbodiesweretakenoutbyusingemergencygastrospocyaftergeneralanesthesiawithkataminandpropofol,usingradiographiclocalizationbeforeoperation.Choosedifferenttoolsasrat-toothforcepsorba
6、sketaccordingtoforeignbodies’typesandforms.Aftertheoperationthepatientsremainedfortwodaysforcomplicationobservation.Meantime,useacidsuppressionmedicinesfor1or2daysinviewofthefactthatwhethertheforeignbodycausedmucosaldamageornot.ResultAmong46patients,35boysand11girls.Age:6mo
7、nths〜8yearsold.Amongthem,5patients<1yearold,30patientsbetween1〜3yearsold,8patientsbetween3〜7yearsold,3patients>7yearsold.Mistakingtime3h〜6d;46foreignbodiesintotalin46patients;Amongthosebodiesare39coins,3batteries,1pencap,1datepit,1paperclip,1ring.In41casestheforeignbodywasi
8、nlaidinupperoesophaguswhile5casesinstoma
