罕见婴儿咽颈部巨大异物1例

患儿,男,10个月.因钢笔套口内刺入致咽颈部疼痛、出血1 h,于2003年10月12日入院.入院1 h前玩耍时不慎摔倒,约5 cm长的钢笔套自口刺入,出现咽、颈部疼痛并呼吸较急促,流出鲜红色血液约25 ml.CT示:一约5 cm长的金属异物自右侧咽腔突向右侧颈部皮下,经颈部动、静脉区,异物头端(尖部)达颈部皮下,尾端位于咽腔黏膜下.     

诊治咽部异物的临床体会

咽异物是耳鼻咽喉科最常见的急症之一，现将近几年来所诊治的病例总结分析如下。     

误吞鱼刺致颈部脓肿1例

患者 ,男 ,45岁。发现颈部包块 1年来我院就诊。入院前 1年 ,患者发现颈部右侧中上部有一鸡蛋大小包块 ,无自觉疼痛 ,不呈进行性长大。入院时检查咽喉无充血、肿胀 ,无异物、新生物。甲状软骨浅面有一包块 ,约 4cm× 4cm× 3cm大小 ,位于甲状软骨板下缘与舌骨之间 ,表面皮肤色泽正常 ,无充血 ,触之轻压痛 ,质软 ,无血管搏动感。颈部B超示包块内为液性暗区。初步诊断 :甲状舌骨囊肿。在局麻下行颈部包块摘除术 ,右侧颈前甲状软骨与舌骨之间作长约 4cm的横切口 ,逐层分离见肌层深面有一约 3cm× 3cm× 2cm大小脓肿 ,脓肿中央有一约 2 .5cm长…     

误吞异物迁移至颈部伴感染1例

<正>咽喉部异物以及食管异物是耳鼻咽喉科常见病,但是由于患者不予重视或者个别医生疏忽大意、不够细心,由此造成的漏诊、误诊会导致患者病情加重、恶化,甚至可能危及生命。现将我们诊治的1例误吞异物迁移至颈部伴感染的患者资料报告如下。1资料与方法1.1一般资料患者女,52岁,因"咽喉部疼痛伴吞咽梗阻感20 d"于2013年3月22日入院。患者半年前进食鱼汤时误将鱼刺样异物吞下,伴有鱼刺     

颈部异物炎性包块误诊甲状舌管囊肿1例

患者，男，40岁，因颈前部包块10天收入我院。10天前发现颈前部有一包块，伴轻微疼痛，讲话、吞咽时疼痛加重，头偏向左侧疼痛更明显，无发热、咳嗽等症状。既往无外伤史，但1个月前有鱼刺伤舌史，之后有反复咽痛、咽异物感症状。曾在外院诊断为咽炎，给以抗炎药物反复治疗。入院前5天在某市级医院行包块B超检查，考虑“甲状舌管囊肿”。     

颈部穿通性异物损伤的诊治

颈部穿通性异物损伤是指异物从颈部进入,穿通咽、喉、气管或造成大血管、神经等部位的损伤。因颈部结构复杂,重要器官密布,潜在腔隙较多,这些损伤可直接或间接地引起严重的并发症。现将1990年5月至2004年5月间我院诊治的6例典型病例资料报告如下。     

中药“消结康”对颈部炎性包块的治疗作用

中药消结康胶囊由莪术、三棱、香附、黄独、瓜等组成，其治疗作用主要是破气行血、理气解郁，清热涤痰、宽胸散结、消积止痛。颈部炎性包块病因复杂，仅用抗菌素治疗效不佳。综合使用抗菌素和消结康比单独使用时缩短疗程，提高疗效。     

咽喉部鱼刺异物迁移致颈部脓肿分析

目的　探讨咽喉部鱼刺异物迁移致颈部脓肿的临床特征、辅助检查、治疗手段及预防策略。方法　回顾性分析8例咽喉部鱼刺异物迁移致颈部脓肿的临床资料。结果　7例有异物误咽史。2例鱼刺迁移至胸锁乳突肌内,3例至舌骨舌肌内,1例至甲状软骨上角与颈动脉鞘之间,1例至咽后间隙,1例至甲状腺内侧。6例行彩色B超检查,5例发现异物。所有患者均行颈部CT检查,4例发现异物。全部患者均通过颈外侧入路颈部探查取出异物。结论  对伴有异物吞咽史的颈部脓肿患者首先考虑异物迁移。彩色B超检查有明确价值,薄层CT及三维重建可作为补充检查手段,手术为首选。医疗安全教育、提高医患警惕为主要预防手段。     

颈部异物的手术策略探讨

颈部外伤并异物存留时,因异物直接损伤或感染等间接损伤可引起严重并发症。2003年以来我们治疗颈部异物22例,现报告如下。     

A foreign body in the pharynx migrating through the internal jugular vein

We present an unusual and a rare case study of a 45-year-old woman who had swallowed a sharp pointed metallic foreign body while eating meat. The foreign body had migrated from the cricopharynx through the parapharyngeal space and penetrated the internal jugular vein over a period of 10 days presenting as a tender neck swelling. The management of this case is discussed here in brief.     

Subjective neck pain or foreign body sensation and the true location of foreign bodies in the pharynx

Conclusion: The location of the foreign body did not correspond well to the location of pain reported by patients. When patients present with foreign bodies in the pharynx, in addition to recording the location of pain and foreign body sensation, clinicians should perform a comprehensive and thorough oropharyngeal examination to avoid misdiagnosis. Objectives: Physicians are often guided by patient-indicated locations of pharyngeal foreign bodies. In this study, we aimed to determine the correlation between the location of the subjective neck pain or foreign body sensation and the true location of the foreign body. Methods: We prospectively studied 90 patients who had pharyngeal foreign bodies removed at MacKay Memorial Hospital. We divided the head and neck into 10 zones according to the superficial anatomy. Subjective location, examination findings, and actual foreign body location were recorded and compared. Results: The overall subjective and true locations of the foreign body were poorly correlated (kappa 0.27, p = 0.003). The positive predictive value (PPV) for the midline neck was 68%, which was higher than that on either lateral side of the neck. PPV above cricoid cartilage level was 66%.     

食管异物引发食管穿孔的处理

目的:探讨食管异物引发食管穿孔的有效处理方法。方法:回顾性分析我科处理的7例食管异物引发食管穿孔及各种并发症的患者资料。结果:6例经手术处理,3～18d(平均14.2d)治愈;1例单经保守治疗,49d治愈。结论:取出异物、修复瘘口、切开引流、控制感染和营养支持治疗等是确实有效的综合治疗措施;单经保守治疗有效,但治愈时间较长。