纤维鼻咽喉镜钳取下咽部异物2526例的临床观察

目的探讨提高治疗下咽部异物取出方法。方法在局麻纤维鼻咽喉镜活检钳钳取下咽部异物2 526例患者。结果 2 526例下咽部异物均顺利取出,无损伤、感染等并发症发生。结论局麻纤维鼻咽喉镜钳取下咽部异物,患者痛苦少、时间短、操作简便。     

经口进路在电子喉镜下钳取下咽异物152例临床分析

目的:探讨经口进路电子喉镜下钳取下咽异物的应用价值.方法:回顾性分析利用Olympus电子喉镜经口进路对门诊下咽部异物及怀疑有下咽部异物患者152例的临床资料.结果:152例患者中103例发现有异物,并在镜下成功取出;49例未见异物的检查结果为咽部粘膜充血或粘膜溃疡,其中有7例见小血肿形成,经抗炎治疗一周后异物感症状消失,复查均未见异物遗留.结论:经口进路在电子喉镜下探查或取出下咽部异物具有成功率高、病人痛苦少、简便快捷、无创等优点,值得推广应用.     

经电子喉镜钳取下咽部异物的护理配合

总结了64例经奥林巴斯电子喉镜及视频系统检查并使用配套活检钳钳取下咽异物的护理配合,主要包括对患者做好心理护理、细致宣教、充分麻醉,熟练配合医生检查,并根据异物的位置和方向,调整活检钳开口方向,咬紧异物,收紧异物钳,将活检钳与喉镜同时撤出,注意在鼻咽部合理调整位置,使异物与鼻腔通道平行,避免损伤鼻腔黏膜。动作轻巧、熟练、快速,与医生配合默契。64例患者均成功取出异物,无并发症发生,满意度高。认为电子喉镜下探查或取出下咽部异物具有操作简便、视野清晰、安全准确、适宜人群广泛、患者痛苦小、局部创伤轻微等优点,值得推广。熟练的护理操作配合更是经电子喉镜下检查并钳取下咽异物顺利进行的重要措施。     

电视纤维喉镜在咽异物诊疗中的作用

咽异物是门急诊中的多发病之一,大多数在压舌板,间接喉镜或间接鼻咽镜下可发现并取出。但在某些情况下(如病人配合极差,异物较小或位置隐蔽等),常规方法较难达到目的。近两年来我们成功地在电视纤维喉镜下取出上述情况下的咽异物13例,收效较好。现报告如下:1　临床资料13例患者中,1例小儿(9岁)咽异物,常规检查不合作,采用电视纤维喉镜检查后,取出鱼刺一根,长约0.5ｃｍ;5例成人间接喉镜下梨状窝鱼刺多次夹取不成功,致周边组织损伤肿胀,在电视纤维喉镜下顺利取出鱼刺,长约0.3～0.7ｃｍ不等;3例鼻咽部鱼刺,长约0.3～0.5ｃｍ;3例扁桃体下极鱼刺,…     

舒适护理在纤维喉镜下咽喉部异物取出患者中的应用

目的:探讨舒适护理在纤维喉镜下咽喉部异物取出患者中的应用方法及效果。方法:将240例确诊为咽喉部异物的患者随机分为对照组和观察组各120例,对照组给予传统护理,观察组给予舒适护理,比较两组患者恶心反应、取出异物时间及满意度情况。结果:观察组不良反应发生率明显低于对照组,取出异物时间短于对照组,患者满意度高于对照组,比较差异均有统计学意义(P=0.000)。结论:将舒适护理应用于纤维喉喉镜下咽部异物取出术中,有效提高了患者舒适度,缩短了手术时间,提高医护人员工作效率的同时提高了患者满意度。     

电视动态观察喉镜下取咽异物68例临床分析

我们自2004年1月至2006年1月采用动态喉镜对常规检查发现不了的咽异物进行检查,取出异物共68例.     

电子喉镜在喉科疾病诊治中的应用3628例分析

目的：探讨电子喉镜在喉部疾病诊断中的价值及其在喉部疾病治疗中的作用。方法：采用电子喉镜对有喉部症状的患者行喉部检查和治疗。结果：3628例患者顺利接受了检查，并得到诊断。768例声带息肉和249例声带小结患者在电子喉镜下作了息肉或小结的切除，113例下咽和喉部的异物患者在电子喉镜下取出异物，91例其他喉部疾病患者接受了电子喉镜下的相应治疗。结论：电子喉镜是喉部疾病诊断和治疗的一种新的有用工具，值得推广应用。     

电视纤维喉镜下取喉咽部异物的临床应用

摘要 目的 观察电视纤维喉镜下取喉咽部异物的临床应用价值。方法 我科自2004年8月——2006年8月间，采用电视纤维喉镜取出喉咽部异物68例，均为门诊病例，病人取座位，常规咽喉部黏膜表面麻醉后，将纤维喉镜经鼻腔导入咽喉部，发现异物后，插入活检钳，调整钳头方向，夹紧异物，与纤维喉镜 一并取出。结果68例喉咽异物在电视纤维喉镜下全部顺利取出。结论 电视纤维喉镜下取喉咽部异物方法简便，成功率高，可减轻患者痛苦。     

下咽部异物误诊为颈部感染二例并文献复习

目的探讨下咽部异物的临床特征、诊治方法及误诊原因,以减少临床误诊误治。方法回顾性分析我院收治的误诊为颈部感染的下咽部异物2例病例资料,并复习相关文献。结果本组2例男性,均以颈部疼痛为主要症状就诊,初诊误诊为颈部感染,给予抗感染对症等治疗效果欠佳。分别行纤维喉镜、颈胸部CT及食管造影等检查,明确诊断为下咽部异物。行颈侧切开术+异物探查取出术+咽瘘修复术,2例术后恢复良好。结论下咽部异物位置隐蔽,临床症状不典型,尤其病程较长时容易误诊。对颈部感染经抗感染治疗效果欠佳的患者,临床应考虑到下咽部异物可能,尽早完善相关检查,以减少误诊误治。     

电子喉镜下儿童咽喉部异物取出的经验总结

目的 总结儿童咽喉部异物经电子喉镜下取出的经验.方法 采用电子喉镜对2019年10月至2021年3月因咽喉异物就诊于蚌埠市第三人民医院耳鼻咽喉科门诊的133例患儿进行异物探查或取出.观察记录异物取出方式,异物类型和部位.结果 133例患儿中,115例发现并去除异物,其中106例经鼻腔取出;3例异物较大,经口异物钳夹出;...     

Foreign body in the hypopharynx--an unusual presentation.

A case is described of a foreign body (a metallic paper clip) in the hypopharynx of an 18 month old child presenting with recurrent respiratory tract infections. The child was treated with antibiotics at two accident and emergency departments without any benefit. A high degree of suspicion is necessary in young children, as a history of ingestion of a foreign body may not be forthcoming. It is important to be aware of the possibility of a foreign body in young children, particularly when the clinical presentation is atypical.     

Life threatening airway obstruction: a hazard of concealed eating disorders.

The ingestion of unusual objects is not uncommon in florid mental illness. Less common is the accidental ingestion of a foreign body which has been used to induce vomiting. A case is reported of complete dysphagia that resulted from impaction of a plastic fork in the hypopharynx. The patient had been attempting to induce vomiting and, as a result of the presentation, was found to be suffering from a previously concealed eating disorder (bulimia). Self induced vomiting is one criterion for the diagnosis of bulimia and a review of the literature indicates that accidental ingestion of large foreign bodies is an increasingly familiar hazard of occult bulimia.     

纤维喉镜下声带息肉、声带小结摘除术2102例分析

目的：总结纤维喉镜下声带息肉及小结摘除的治疗效果。方法：回顾分析2102例局部麻醉下经纤维喉镜摘除声带息肉及小结的有效性及安全性。结果：纤维喉镜下摘除声带息肉及小结的总有效率为97．6％,术后恢复快,无并发症。结论：纤维喉镜下声带息肉及小结摘除术是一种方便可行,疗效好,值得推广的方法。     

Lodged oesophageal button battery masquerading as a coin: an unusual cause of bilateral vocal cord paralysis

An 11-month-old girl with an oesophageal foreign body was presented: from the radiographic appearance it was presumed to be a coin. Microlaryngoscopy 5 h after ingestion revealed a button battery impacted in the hypopharynx with severe damage to the oesophageal mucosa. The patient was intubated for 6 days in the intensive care unit because of stridor and respiratory distress. Repeat microlaryngoscopy demonstrated bilateral vocal cord palsy, which was presumed to be secondary to the involvement of the recurrent laryngeal nerves in the injury. We recommend that in the absence of a history of observed ingestion, it should be assumed that coin-like foreign bodies are button batteries until proven otherwise.     

经纤维支气管镜应用冷冻治疗仪行儿童支气管异物取出术的有效性及安全性

目的探讨经纤维支气管镜应用冷冻法行儿童支气管异物取出术的有效性及安全性。方法对72例支气管异物的患儿进行纤维支气管镜下应用冷冻治疗仪行异物取出术,并对患儿在术中和术后并发症进行观察。结果所有患儿支气管异物均顺利取出。72例患儿中,术中并发症以一过性低氧血症最常见,共37例,以小年龄组最高,随年龄增大而降低;术后并发症则以咳嗽加重最常见,共20例。术后随访未发现严重并发症。结论纤维支气管镜下应用冷冻治疗仪行儿童支气管异物取出术,虽然具有一定的并发症,但操作时间短,并发症轻微。具有较高的应用价值及安全性。     

螺旋CT多平面重建在小儿气道异物中的诊断价值

目的评价螺旋CT多平面重建(MPR)在小儿气道异物中的诊断价值。方法对75例可疑为气道异物的患儿行螺旋CT容积扫描,对CT薄层图像进行多平面重建,显示气道异物后,再经支气管镜下取异物。结果70例MPR显示气道异物的患儿,经支气管镜检查均于MPR显示高密度影处发现异物并取出。5例MPR无异物显示者气管镜检查未查见异物。其中总气管内异物10例,右支气管32例,左支气管28例。结论MPR对气道异物的显示率高、定位准,能明显提高气道异物的术前确诊率,具有重要的诊断价值。     

下咽癌中CDC25A基因的表达及临床意义

目的探讨细胞分裂周期素25A(CDC25A)在下咽癌组织中的表达及其与各临床病理因素的关系。方法采用免疫组化S-P法检测35例下咽癌组织和20例下咽正常黏膜组织中的CDC25A的表达情况。结果①CDC25A在下咽癌组织中的阳性表达率为57%,高于下咽正常黏膜组织10%的表达率(P<0.05)。②CDC25A在有淋巴结转移和无淋巴结转移组、临床Ⅲ～Ⅳ期和临床Ⅰ～Ⅱ期组、高分化和中低分化组中的差异显著(P<0.05)。CDC25A蛋白表达在不同肿瘤大小、性别、年龄组间差异无统计学意义(P>0.05)。结论 CDC25A蛋白的高表达可能促进下咽癌的发生、发展,其蛋白检测可作为判断下咽癌分化、浸润、转移和分期的重要指标。     

Endoscopic management of foreign bodies in the upper gastrointestinal tract: report on a series of 414 adult patients

BACKGROUND AND STUDY AIMS: Ingestion of foreign bodies is a common occurrence. Few papers in the literature report experience and outcome at tertiary centers. The aim of this paper is to report the management and the outcomes in 414 patients admitted for suspected ingestion of foreign body between May 1995 and December 1999. METHODS: A plain radiographic film of the neck, chest or abdomen was obtained in the case of radiopaque objects, and in order to rule out suspected perforation: in such cases a computed tomography (CT) study was also performed. All patients were asked to give their informed consent, which was refused by three patients. Anesthesia was always used, either conscious sedation (86.8 %), or general anesthesia in the case of poor patient tolerance (13.2 %). All patients underwent an endoscopic procedure within six hours of admission. A flexible scope was used in all patients and a wide range of endoscopic devices was employed. RESULTS: Foreign bodies were found in 64.5 % of our patients. Almost all were found in the esophagus. The types of foreign body were very different, but they were chiefly food boluses, bones or cartilages, dental prostheses or fish bones. In three patients (1.1 %) it was impossible to endoscopically remove the foreign body, which was located in the cervical esophagus: all these three patients required surgery. No complications relating to the endoscopic procedure were observed, but 30.7 % of patients had an underlying esophageal disease, such as a stricture. Only eight patients required a second endoscopic procedure, performed by a more experienced endoscopist. CONCLUSION: Foreign body ingestion represents a frequent reason for emergency endoscopy. The endoscopic procedure is a successful technique which allows the removal of the foreign bodies in almost all cases without significant complications. Surgery is rarely required.     

Clinically unsuspected foreign bodies: the importance of sonography.

OBJECTIVE: To show the value of sonography in the detection of clinically unsuspected foreign bodies appearing as soft tissue masses. METHODS: High-resolution B-mode and color Doppler sonography was performed in 288 patients referred with superficial soft tissue masses over a period of 2 years. RESULTS: In 8 lesions in 6 patients, sonography showed small curved or linear echogenic structures surrounded by hypoechoic masses characteristic of foreign bodies with granulation tissue. One lesion had increased vascularity on color Doppler sonography. Patients were referred for other imaging studies, including magnetic resonance imaging, computed tomography, and bone and labeled red blood cell scintigraphy, which did not add relevant information. Three patients underwent surgery; foreign bodies were found in 2, and infected granulation tissue was found in 1. Spontaneous resolutions and no growth of the lesions were seen in the other 2 patients. CONCLUSIONS: The possibility of a foreign body should be considered when scanning soft tissue masses even in the absence of a relevant clinical history. Once a foreign body is diagnosed, no further workup is indicated.     

鼻内镜在鼻咽癌诊断中的应用探讨

目的探讨鼻内镜在鼻咽癌诊断中的应用价值。方法对70例临床拟诊鼻咽癌病人行鼻内镜下鼻咽部活检。其中50例鼻内镜下发现鼻咽部新生物、黏膜隆起光滑及粗糙不平可疑病灶；另20例鼻内镜下活检前曾在间接鼻咽镜、纤维鼻咽镜下数次活检，均为阴性。结果50例可疑病灶中，确诊鼻咽癌30例(60．0％)，恶性淋巴瘤2例(4．0％)，慢性炎症18例(36．0％)；另20例中，鼻内镜下发现鼻咽部新生物及无异常各10例，除1例经鼻内镜下2次活检确诊鼻咽癌外，余均1次确诊。结论对临床高度怀疑鼻咽癌且间接或纤维鼻咽镜下活检阴性者，应改在鼻内镜下活检或直接行鼻内镜下检查及活检；对鼻咽部外观无异常者，应行鼻咽部CT检查甚至CT指导下的进一步活检，以防漏诊黏膜下型、浸润型鼻咽癌。