共查询到20条相似文献,搜索用时 74 毫秒
1.
[目的]回顾性分析189例上消化道异物的内镜处理方法。[方法]选择近期189例采用内镜诊治的上消化道异物病例。术前结合影像确定异物部位及性状,制定合理的取出方案,术中选择合适的器械将异物取出。[结果]189例上消化道异物病例中,成功使用内镜取出180例,取出成功率为95.2%。取出异物耗时7min-4h,平均耗时(45.4±39.7)min。未见穿孔、大出血等严重并发症,3例黏膜发生轻度破损。[结论]内镜医师术前严格掌握适应证,并进行充分的影像学探查分析,优化内镜取出方案,术中谨慎操作是提高取出成功率的关键。 相似文献
2.
经内镜取出上消化道异物的体会 总被引:19,自引:1,他引:19
经内镜取出上消化道异物的体会程凤岐杜红孟江云黄英才汪鸿志程留芳1976年~1997年,我院共经内镜取出307件上消化道异物,现将摘取方法和体会报告如下。1.一般情况:本组男158例,女117例,年龄6个月~78岁,中位年龄32岁,5岁以下46例。2.... 相似文献
3.
目的 系统评价国内上消化道嵌顿异物内镜取出失败的影响因素.方法 用循证医学方法,检索中文数据库中有关内镜取上消化道异物的文献并获取全文,根据严格的纳入和排除标准对文献进行筛选,从1975年至2010年10月共纳入215项研究(共904例取出失败),均为回顾性队列研究.然后对入选文献进行数据提取、汇总及归纳分析.结果 结果显示内镜下取金属类异物的失败率较高(23.0%,78/371);异物吞入24h之后内镜取出失败的比例(97.5%,79/81)明显高于24h内取出失败的比例(2.5%,2/81);内镜下取嵌顿于食管的异物的失败率(49.8%,213/428)较胃(29.0%,124/428)、十二指肠(17.0%,73/428)、会厌部(4.2%,18/428)的失败率高;特殊人群(被管制人员、精神心理异常患者)较一般患者失败率高[(8.4%,29/346)比(4.2%,875/21071),P=0.0001).术前行胸腹部X线检查和CT检查病例的失败率(3.7%,22/591)低于只行胸腹部X线检查(4.3%,788/18450)或钡餐检查(5.1%,50/980)的失败率.失败患者中有9例死亡病例,均为锐利骨类异物的嵌顿,8例嵌顿于食管中上段,6例嵌顿时间超过24h.结论 异物类型、大小、嵌顿时间、所处消化道位置以及患者的人群特点与内镜下取异物失败率的高低有关.做好充分的术前准备、加强特殊人群管理,改善饮食习惯,及时就诊是控制失败率的关键. 相似文献
4.
内镜下治疗上消化道异物30例 总被引:1,自引:1,他引:1
目的总结内镜对上消化道异物的治疗体会.方法男17例,女13例,年龄4岁~94岁;异物部位:异物在食管上、中、下段、胃底、体、窦部及十二指肠球部均可存在。异物种类达18种30件之多.急诊取异物25例,择期5例.根据异物性质、大小及部位,在内镜直视下,分别采用活检钳、圈套器或三爪钳将异物取出,细小的金属类异物如观察不清时,则通过X线协助取出.结果28例经内镜取出异物28件,成功率93.3%,术后1h~2h可进食流质或半流质,伴有消化道粘膜损伤或原已有糜烂、溃疡者,给予抗生素、制酸剂和胃粘膜保护剂,所有病例无并发症出现.结论熟练的内镜操作对上消化道异物的治疗是一种快捷、安全的方法. 相似文献
5.
通过试件试验,提示了ZG25钢疲劳浅裂纹的长度与扩展速率和门槛值的关系,以及扩展速率与应力强度因子幅的变化关系。分析确定了ZG25钢的浅裂纹最大尺寸。用有效应力强度因子幅,并在其中引进材料的参数,作为裂纹扩展的控制参量,使浅裂纹和长裂纹的数据点处在同一个分布带内,即可用一个关系式来描述浅裂纹和长裂纹的扩展规律。 相似文献
6.
我院自1992年~1996年4年间共收治小儿上消化道异物54例,其中金属性异物31例,均经内镜取出,未发生严重并发症,现报告如下。 相似文献
7.
上消化道异物的内镜治疗济南市中心医院(250013)张书元张峰上消化道异物多为误食所致,少数为内源性异物-胃结石。较大的异物可滞留于食管,多数可通过食管进入胃腔。异物的种类很多,国内多分为金属类与非金属类。金属类异物中最常见的有硬币、金属钮扣、发夹、... 相似文献
8.
9.
使用异物保护装置经内镜取上消化道特殊异物 总被引:4,自引:0,他引:4
目前,国内外临床医师对误入上消化道的体积较大、形态不规则、尖锐质硬的特殊异物的安全取出的问题仍未解决[1]。尽管多年来,我们已经为320例上消化道异物病人取出异物387件,但是在此期间,于1991年我们曾为一误吞双钩假牙8天的病人,经内镜取出时发生了食管穿孔之严重并发症[2]。为此,经过多年反复研究和试验,我们研制出异物包裹等安全性器械。自1994年~1999年2月我们用其成功地治疗上消化道异物病人43例。1 资料与方法11 资料 (1)本组43例病人,男36例,女7例。年龄10~77岁。60岁以上老年人7例。(2)异物情况:金属类有剪刀、双钩假牙、鞋… 相似文献
10.
内镜下取上消化道异物的评价 总被引:2,自引:0,他引:2
消化道异物可见于任何年龄。儿童吞入的异物大多是小的和无毒的。小的异物通常可自然地通过胃肠道排出。成年人易于吞入特殊的异物或致异物嵌顿。这些吞服者多见于食管狭窄或食管其它疾患、精神病、酗酒、狱中犯人及弱智者。 10例有食管嵌顿病人中 ,80 %有食管狭窄 (肿瘤、术后、吻合口炎 )及食管疾患。因此活动异物易滞留在食管狭窄部、胃贲门幽门部、回盲部及直肠。以上消化道为多见。1 临床资料我院近年来收治上消化道异物 17例 ,男 16例 ,女1例 ,年龄 2 2~ 67岁 ,食管异物 10例 ,胃内异物 7例。食管异物 :肉团块 2例 ,蛋黄 1例 ,鱼刺 … 相似文献
11.
Choichi Sugawa Hiromi Ono Mona Taleb Charles E Lucas 《World journal of gastrointestinal endoscopy》2014,6(10):475-481
Foreign body ingestion is a common condition, es-pecially among children who represent 80% of these emergencies. The most frequently ingested foreign bodies in children are coins, toys, magnets and batter-ies. Most foreign body ingestions in adults occur while eating, leading to either bone or meat bolus impaction. Flexible endoscopy is the therapeutic method of choice for relieving food impaction and removing true foreign bodies with a success rate of over 95% and with mini-mal complications. This review describes a comprehen-sive approach towards patients presenting with foreign body ingestion. Recommendations are based on a review of the literature and extensive personal experi-ence. 相似文献
12.
Chong Geng Xiao Li Rong Luo Lin Cai Xuelian Lei 《Scandinavian journal of gastroenterology》2017,52(11):1286-1291
Objective: To report our endoscopic outcomes and explore the effects of duration of impaction and anesthetic methods on the endoscopic removal of foreign bodies in the upper gastrointestinal tract.Methods: All consecutive patients with suspected foreign body (FB) ingestion between January 2013 and June 2016 were enrolled. Demographic, clinical and endoscopic data were collected and analyzed.Results: A total of 1294 patients aged seven months to 94 years were enrolled. Odynophagia (415 cases, 32.1%), FB sensation (340 cases, 26.3%) and sore throat (267 cases, 20.1%) were the most frequent complaints. The duration of FB impaction ranged from 4?h to over two years. Anatomically, foreign bodies were most commonly located in the esophagus (n?=?1025, 86.9%). Bony foreign bodies comprised the majority of identified foreign bodies. The most common underlying pathology was esophageal stricture (38 cases, 53.5%). Nearly half of the patients (49.9%) developed complications. As the duration of impaction increased, the success rate by endoscopy decreased (p?.001), and the complication rate increased (p?.001). Endoscopic management under general anesthesia didn’t improve the success rate or lower the complication rate compared with topical pharyngeal anesthesia (p?=?.793 and p?=?.085). Age?≥60, duration of impaction longer than one day, impaction in the esophagus, and sharp foreign bodies were identified as risk factors for complications.Conclusions: Delayed flexible endoscopy in patients, especially elderly patients, with sharp FB impactions in the esophagus results in worse endoscopic outcomes. Endoscopic management under general anesthesia did not improve the therapeutic results compared with topical pharyngeal anesthesia. 相似文献
13.
R Kochhar R Aggarwal M K Goenka S Mehta S K Mehta 《Indian journal of gastroenterology》1990,9(4):283-284
Records of 55 consecutive patients who had ingested foreign bodies were reviewed retrospectively. Foreign bodies were located in the esophagus, stomach and duodenum in 25, 27 and 3 patients respectively. Eleven of these passed through the entire gastrointestinal tract spontaneously and uneventfully. Endoscopic extraction was successful in 36 patients while 8 needed surgical removal of the ingested object. Only one death was encountered. We conclude that using simple guidelines, foreign body ingestion can be managed with a low incidence of complications and mortality. 相似文献
14.
Management of foreign bodies of the upper gastrointestinal tract 总被引:6,自引:0,他引:6
W A Webb 《Gastroenterology》1988,94(1):204-216
In the United States, 1500 people die yearly of ingested foreign bodies of the upper gastrointestinal tract. The flexible esophagogastroduodenoscope has had a major impact on the treatment of these foreign bodies. The following discussion includes the management of coins, meat impaction, sharp and pointed objects, button batteries, and cocaine packets; and it reflects both a personal experience and a review of the literature. The uses of the rigid and the flexible endoscopes, the Foley catheter, glucagon, papain, and gas-forming agents are presented. The cost-effectiveness impact of the flexible endoscope is also detailed, and morbidity and mortality rates for foreign body management are included. 相似文献
15.
J J Sebastián Domingo A De Diego Lorenzo L Santos Castro D Castellanos Franco P Menchén 《Revista española de enfermedades digestivas》1990,77(4):259-262
From 1983 to 1989, the Unidad de Endoscopias has attended 424 cases of foreign bodies located in the gastrointestinal tract, most of them in the esophagus. The mean age of the patients was 49 years. The commonest foreign bodies were food particles and the most common symptom was acute dysphagia. The most frequent localization of impaction was the cricopharyngeal sphincter (Killian's mouth). In 89% of the cases the foreign body could be removed endoscopically. The most common underlying pathology was hiatal hernia. There were severe complications related to the presence of the foreign body in 4.5% of the cases; one death was due to aorto-esophageal fistula. Foreign bodies, mainly impacted food particles (p less than 0.001), are most frequent in patients over 65, mainly females (p less than 0.01). 相似文献
16.
郑斯杰 《中国实用内科杂志》2011,(10):791-792
食管、胃内异物是常见的急症,常引起食管、胃黏膜损伤,甚至引起大出血、上消化道穿孔等严重并发症。经内镜取上消化道异物简便、创伤小、成功率高,其已作为治疗上消化道异物的首选方法[1]。现将我院内镜下取上消化道异物的体会总结如下。 相似文献
17.
18.
Chiu YH Hou SK Chen SC How CK Lam C Kao WF Yen DH Huang MS 《The American journal of the medical sciences》2012,343(3):192-195
IntroductionThe objective is to evaluate the diagnosis of foreign body (FB) ingestion and report on the endoscopic management in Taiwan.MethodsThis retrospective study enrolled 159 adult patients with confirmed diagnosis of upper gastrointestinal FBs who received endoscopic management in the emergency department.ResultsThe patients’ mean age was 57.0 ± 19.2 years, and 66 (37.7%) of the patients were 65 years or older. Majority had a clear history and symptoms of FB ingestion. However, 9 (5.7%) initially ignored the accidental swallowing of FBs and were diagnosed late. The mean time spent for diagnosis was 1.8 days in those with uncertain history. Only 47.1% of those with radiographic studies had positive findings. Fish bones, press-through package and dentures were the most common culprits in this population of Asian elderly. Majority of FBs were located in the esophagus, especially in the upper third. Endoscopic FB extraction was successful in 96.9% of cases, while surgery was required in only 5 patients. The complication rate was 6.9%, including mucosal laceration (n = 10) and suspected perforation (n = 1), all of which were successfully managed conservatively. There was no death due to FB ingestion or endoscopy.ConclusionsIn FB ingestion, history usually points toward the diagnosis. Patients with an uncertain history are usually diagnosed late, and plain radiography cannot reliably predict the presence of FB. Endoscopic management is safe and effective for FBs. 相似文献
19.
Nine polyps retrieved from the upper gastrointestinal tract by endoscopic polypectomy in nine patients are reported. Polyps were removed from the distal esophagus (1), stomach (7) and duodenum (1). Dysphagia, obstructive jaundice and upper gastrointestinal bleeding were the presenting features in four patients. In five patients gastric polyps were detected incidentally at endoscopy. Of the nine polyps, six were adenomas, two were hyperplastic polyps and one in the esophagus was inflammatory. All the polyps could be retrieved completely and there were no complications. Thus polyps do occur in the upper gastrointestinal tract in India; their electrosurgical removal is easy and safe and allows histopathological examination of the entire polyp. 相似文献
20.
The realm of endoscopy has gone from that of diagnosis to that of diagnosis and therapy. Therapeutic endoscopy is a rapidly advancing frontier in the field of gastroenterology. Its use in securing haemostasis has recently flourished. Considerable progress has been made. Various experimental techniques have been tried and found lacking, while others, such as laser photocoagulation, electrohydrocoagulation and endoscopic sclerotherapy, are proving to be very useful. The mortality for upper gastrointestinal bleeding has remained high for decades, despite recent advances in medicine. This may be related to the shift in the population toward the older age group. Recent advances in endoscopic haemostasis seem to be showing promise in improving survival rates. This is a result of improved recognition of risk factors, including the stigmata of recent haemorrhage, of early surgical intervention in the elderly, and of the ability to reliably secure haemostasis endoscopically. This chapter gives an account of the various techniques of endoscopic haemostasis and explains the numerous controversies through the discussion of selected experimental and clinical trials. 相似文献