对食道按电池摄入的解剖学考虑对结果和成像的成像
William G Cohen1, Moira Mchugh2, Terri Giordano2
1Division of Otolaryngology, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA.
International journal of pediatric otorhinolaryngology
|December 3, 2023
概括
儿童的按电池 (BB) 摄入最常影响宫食道,导致严重损伤和狭窄,特别是在年轻患者中. 并发症最好通过临床指示而不是常规监测来检测.
科学领域:
- 儿科胃肠病学 儿科胃肠病学
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 紧急医疗 紧急医疗
背景情况:
- 按电池 (BB) 在幼儿中存在严重的发病和死亡风险.
- 关于食道冲击位置与患者结果之间的关系或监测成像的必要性存在有限的数据.
研究的目的:
- 为了研究按电池冲击在食道的位置和患者的结果之间的关联.
- 为了确定监控成像在检测并发症方面的有效性.
主要方法:
- 从2018年到2022年,在一个机构接受按电池摄入治疗的患者的回顾性图表审查.
- 对按电池位置,患者人口统计,损伤严重程度 (扎尔加粘膜损伤等级) 和并发症发展的分析.
主要成果:
- 宫食道损伤 (50%) 是最常见的,发生在较小的儿童中,并与更严重的粘膜损伤相关 (80%≥IIIB级).
- 持续的食道狭窄发生在60%的宫损伤患者中.
- 并发症主要是通过临床指示评估检测出来的,而不是常规监测 (只有5%的并发症是常规检测出来的).
结论:
- 儿童的宫按电池冲击与年龄较小,损伤严重程度增加和狭窄风险更高有关.
- 临床指示的随访在检测严重并发症方面比常规监测成像更有效.
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