特殊类型食管异物的处理

目的：探讨特殊类型食管异物安全、有效、方便的处理方法。方法：回顾分析1997年1月～2002年6月收治的12例特殊类型食管异物(带金属钩义齿10例，剃须刀1例，金属玩具小飞机1例)的处理过程。结果：5例义齿开胸取出；3例义齿剖腹胃内取出；1例义齿、1例剃须刀、1例金属玩具小飞机异物食管镜取出，1例义齿电子胃镜取出。11例治愈，1例死亡。结论：特殊类型食管异物应尽早尽快手术取出，术前应明确异物种类、取出难易程度、做好应变准备，先行食管镜和电子胃镜试取，试取时宜选择全身麻醉试取失败后应向下推入胃内，剖腹胃内取出异物；下推失败后应尽快开胸取出异物

Management of special type foreign bodies in esophagus

Objective To explore safe,effective and expedient disposal method of special type foreign bodies in esophagus. Methods The disposal process of12cases of special type foreign bodies in esophagus(10cases of metals hook artificial tooth,1case of razor and1case of metal plane toy)was analysed retrospectively from1997.1to2002.6. Results 5cases of artificial tooth were removed off by thoracotomy,3cases of artificial tooth were removed off by gastrotomy,1case of artificial tooth,1case of razor and1case of metal plane toy were removed off by oesophagoscope,1case of artificial tooth was removed off by electron gastroscope.11cases were cured and1case died. Conclusion Special type foreign bodies in esophagus should be removed off as early as possible.Foreign bodies type,difficulty degree of removing off foreign bodies and emergency provision should be prepared preoperatien.Foreign bodies should be tried to remove off by oesophagoscopy and gastroscopy and general anesthesia is selected usually.Foreign bodies should be pushed down to stomach after failure and tried to remove off by gastrotomy.Foreign bodies should be removed off by thoracotomy as soon as possible if foreign bodies pushed down to stomach failed.