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目的探讨处理故意摄入上消化道异物的关键问题。方法分析149例故意摄入上消化道异物患者的治疗经过。结果149例中,通过X线和(或)胃镜找到167件异物,其中1枚缝针深刺入咽部组织,16件在食管,112件在胃腔,7件在十二指肠球部,31件已进入降部以下肠道。经胃镜发现的异物大多可自行排出体外。内镜成功钳取了118例131件异物。22例(占未处理病例数的71%)从大便排出,9例因延迟排出或出现症状而手术。149例无1例造成医源性严重伤害或死亡。结论故意摄入异物经急诊内镜结合X线确认和处理,可消除异物的潜在危险,减少外科手术率,缩短治疗时间。
Objective To explore the key issues in dealing with deliberate ingestion of upper gastrointestinal tract foreign bodies. Methods Analysis of 149 cases of deliberate intake of upper gastrointestinal tract after treatment. Results Of the 149 cases, 167 foreign bodies were found by X-ray and / or endoscopy. One of the stitches penetrated deep into the pharyngeal tissues, 16 in the esophagus, 112 in the gastric cavity, and 7 in the duodenal bulb , 31 have entered the descending part of the intestinal tract. Most of the foreign bodies found by endoscopy can be excreted by themselves. Endoscopic successful clamp took 118 cases of 131 foreign bodies. Twenty-two patients (71% of untreated cases) were excreted from the stool and nine patients were discharged due to delay or symptoms. None of the 149 cases caused serious iatrogenic injury or death. Conclusion Intentional ingestion of foreign body by emergency endoscopy combined with X-ray identification and treatment can eliminate the potential risk of foreign body, reduce the surgical rate and shorten the treatment time.