200例儿童消化道异物的临床特点及并发症影响因素分析

Clinical characteristics of 200 children with foreign bodies in the digestive tract and analysis in risk factors of complications

  • 摘要:
      目的  分析儿童消化道异物的临床特点以及导致并发症的危险因素。
      方法  回顾性分析200例儿童消化道异物患儿的临床资料,总结儿童消化道异物的临床特点,并对消化道异物患儿并发症级别的影响因素进行单因素分析。
      结果  200例患儿中,男童居多,3岁及以下患儿为主,看护人以祖辈老人为主,消化道异物长度或直径以1~2 cm者比率最高,异物类型以硬币比率最高,数量以单个居多,位置以食管居多,异物性状以硬物为主,形状以圆钝形为主,滞留时间不超过8 h者居多,异物取出时间多为送医后2~4 h,取出方式以内镜为主。按照并发症级别的不同将患儿分为普通组178例和危险组22例,单因素分析结果显示,消化道异物长度/直径、异物类型、异物数量、异物位置、异物性状、异物形状、滞留时间、取出方式均是消化道异物患儿并发症级别的影响因素(P < 0.05)。
      结论  儿童消化道异物的临床特点多样,医师应尽早诊断和积极制订方案,并谨慎操作,避免二次伤害,还应认真评估并发症风险和发生情况,做好健康教育,避免再次发生。

     

    Abstract:
      Objective  To analyze the clinical characteristics of foreign bodies in digestive tract, and discuss the risk factors of complications.
      Methods  The clinical data of 200 children with foreign body in digestive tract were analyzed retrospectively. The clinical characteristics of foreign body in digestive tract were summarized. The risk factors of severity of complications of patients with foreign body in digestive tract were analyzed by single factor analysis.
      Results  Out of 200 children, the proportions of boys and those aged under 3 years were the most, and caregivers were their grand-patents. Foreign body with length and diameter of 1 to 2 cm accounted for the most, and coin ratio was the highest in foreign body types, most of the foreign body were single object, and located in digestive tract. They were usually hard, obtuse-shaped stuff, most of them retained less than 8 hours. Most of their removal time was 2 to 4 hours after admission to hospital, and most of them were removed by endoscopy. According to severity of complications, they were divided into general group (178 cases) and risk group (22 cases). Univariate analysis showed that the risk factors of complications of gastrointestinal foreign body included length, diameter of gastrointestinal foreign body, types of foreign body, the number of foreign body, location, texture of foreign body, retention time, and removal mode(P < 0.05).
      Conclusion  The clinical characteristics of children's digestive tract foreign body are various. In the process of treatment, doctors should not only actively carry out diagnosis and program designation, but also operate cautiously to avoid secondary injury. At the same time, clinicians should carefully evaluate the risk degree and occurrence of complications, and perform health education to avoid the recurrence of foreign body.

     

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