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目的探讨自行研制的食管异物取出器介入治疗食管异物的方法与疗效。方法选取1994年～2007年资料完备的食管异物患者39例,5～10岁的10例,系误吞服硬币、玻璃球嵌顿于食管第一狭窄处。18岁1例系囚犯自杀,吞服门窗插销。50岁以上28例,均系晚期食管癌,食管支架置入术后及食管胃吻合口狭窄的病人,异物为肉团、骨块、果核等。透视下先将导丝导管经口腔插入,使导丝导管越过食管异物,送导丝于远端胃腔,并留置导丝。沿导丝放入食管异物取出器,使异物置于取出器哑铃型气囊中央,然后充气,使食管扩张。缓缓拔出取出器,异物随取出器上移并取出。对吻合口狭窄的病人,可先行吻合口狭窄的扩张,使部分残留的碎小异物下移进入胃腔。结果39例病人均一次性取出,梗阻立刻解除,未发生并发症。结论食管异物取出器使用方便、效果好、成功率高,尤以钝性及肉团型异物最佳,但对尖锐状异物有一定限制。
Objective To explore the method and efficacy of self-developed esophageal foreign body extractor for interventional treatment of esophageal foreign body. Methods From 1994 to 2007, 39 patients with complete esophageal foreign bodies and 10 patients aged 5 to 10 years were swallowed by mistake, and glass balls were implanted in the first stricture of the esophagus. A case of 18-year-old prisoner committed suicide, swallow doors and windows latch. More than 50 years of age in 28 cases, both of advanced esophageal cancer, esophageal stent implantation and esophageal anastomotic stenosis of the patients, foreign body for meatballs, bone, fruit and so on. Under the perspective of the first guide wire catheter inserted through the mouth, so that the guide wire catheter esophageal foreign body, send the guide wire in the distal gastric cavity, and indwelling guide wire. Place the esophageal foreign body extractor along the guide wire so that the foreign body is placed in the center of the dumbbell-shaped air bag of the extractor and then inflated to expand the esophagus. Slowly remove the extractor, foreign body with the extractor to move up and remove. Patients with anastomotic stenosis can be anastomotic stenosis of the expansion, so that part of the residual broken small foreign body down into the stomach. Results All the 39 patients were removed at one time, and the obstruction was immediately relieved without any complications. Conclusions Esophageal foreign body extractor is easy to use and has good effect and high success rate, especially blunt and meatball-type foreign body, but it has some limitations on sharp foreign body.