含漱气泡法治疗咽喉部鱼刺嵌顿

doi:10.6040/j.issn.1671-7554.0.2024.0133

摘要/Abstract

摘要： 目的探讨含漱气泡法(gargle-bubble method, GBM)治疗咽喉部鱼刺嵌顿的临床应用可行性。方法回顾性分析2019年1月至2022年12月主诉为咽喉部鱼刺嵌顿的患者531例资料,A组患者误食鱼刺后曾自行采用吞服食醋、馒头等方式处理(n=263);B组患者误食鱼刺后未采取直接采取GBM处置(n=268)。比较两组间有效率。结果 A组吞服食醋、馒头处理鱼刺有效率为15.2%(n=40),84.8%(n=223)患者处理失败,接受进一步医疗处置;B组GBM处理鱼刺有效率为98.1%(n=263),0.8%(n=2)患者拒绝实施GBM,1.1%(n=3)患者处理失败。结论 GBM能有效排出咽喉部鱼刺,操作简单,是咽喉部鱼刺嵌顿的有效急救方案。

关键词: 鱼刺, 咽喉部, 异物, 含漱气泡法

Abstract: Objective To explore the feasibility of using the gargle-bubble method(GBM)to treat laryngopharyngeal fishbone impaction. Methods A total of 531 patients with laryngopharyngeal fishbone impaction from January 2019 to December 2022 were retrospectively analysed. Patients in group A(n=263)swallowed vinegar or steamed buns by themselves, and patients in group B were treated directly with GBM(n=268). The effective rates of the two groups were compared. Results In group A, the effective rate of swallowing vinegar or steamed buns was 15.2%(n=40), and 84.8%(n=223)of patients failed and received further medical treatment. In group B, the effective rate of GBM was 98.1%(n=263), 0.8%(n=2)of patients refused to undergo GBM and 1.1%(n=3)of patients failed to treatment. Conclusion GBM can be considered as a simple and effective self-treatment for laryngopharyngeal fish bone impaction, which is worthy of popularisation and application.

Key words: Fish bone, Laryngopharynx, Foreign bodies, Gargle-bubble method

中图分类号:

R767.8

王新月,王兴蕾,陆美琪,赵洁,王晓川,焦亚,姜笃银,许安廷. 含漱气泡法治疗咽喉部鱼刺嵌顿[J]. 山东大学学报 (医学版), 2024, 62(6): 71-75.

WANG Xinyue, WANG Xinglei, LU Meiqi, ZHAO Jie, WANG Xiaochuan, JIAO Ya, JIANG Duyin, XU Anting. Gargle-bubble method for the treatment of pharyngeal fishbone impaction[J]. Journal of Shandong University (Health Sciences), 2024, 62(6): 71-75.

参考文献

[1] Ballivet-de-Régloix S, Crambert A, Maurin O, et al. Fishbones in the upper aerodigestive tract: a review of 24 cases of adult patients [J]. Iran J Otorhinolaryngol, 2017, 29(93): 215-219.
[2] Geng C, Li X, Luo R, et al. Endoscopic management of foreign bodies in the upper gastrointestinal tract: a retrospective study of 1294 cases[J]. Scand J Gastroenterol, 2017, 52(11): 1286-1291.
[3] Yuan JJ, Ma MJ, Guo Y, et al. Delayed endoscopic removal of sharp foreign body in the esophagus increased clinical complications: an experience from multiple centers in China[J]. Medicine, 2019, 98(26): e16146. doi:10.1097/MD.0000000000016146.
[4] Jayachandra S, Eslick GD. A systematic review of paediatric foreign body ingestion: presentation, complications, and management[J]. Int J Pediatr Otorhinolaryngol, 2013, 77(3): 311-317.
[5] 张雪茹, 李琦. 儿童磁性咽部异物1例[J]. 临床耳鼻咽喉头颈外科杂志, 2018, 32(18): 1432-1433. ZHANG Xueru, LI Qi. A case of magnetic pharyngeal foreign body in children[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2018, 32(18): 1432-1433.
[6] 薛宁, 郭庆伟. 儿童误吞多枚磁性异物导致消化道穿孔1例[J]. 山东大学学报(医学版), 2021, 59(2): 118-119. XUE Ning, GUO Qingwei. A case of digestive tract perforation caused by children swallowing many magnetic foreign bodies by mistake[J]. Journal of Shandong University(Health Sciences), 2021, 59(2): 118-119.
[7] 陈淑梅, 吴佳欐, 李晓艳. 异物导致儿童咽后咽旁间隙脓肿的临床分析[J]. 山东大学学报(医学版), 2018, 56(9): 87-89. CHEN Shumei, WU Jiali, LI Xiaoyan. Clinical analysis of retropharyngeal parapharyngeal space abscess caused by foreign bodies in children[J]. Journal of Shandong University(Health Sciences), 2018, 56(9): 87-89.
[8] Lee CY, Kao BZ, Wu CS, et al. Retrospective analysis of endoscopic management of foreign bodies in the upper gastrointestinal tract of adults[J]. J Chin Med Assoc, 2019, 82(2): 105-109.
[9] Aiolfi A, Ferrari D, Riva CG, et al. Esophageal foreign bodies in adults: systematic review of the literature[J]. Scand J Gastroenterol, 2018, 53(10/11): 1171-1178.
[10] Lu YT, Chen HW, Tseng YY, et al. Factors associated with the true location of ingested fishbones[J]. Eur J Emerg Med, 2019, 26(3): 224-227.
[11] Okan I, Akba?瘙塂 A, Küpeli M, et al. Management of foreign body ingestion and food impaction in adults: a cross-sectional study[J]. Turk J Trauma Emerg Surg, 2019, 25(2): 159-166.
[12] Long B, Koyfman A, Gottlieb M. Esophageal foreign bodies and obstruction in the emergency department setting: an evidence-based review[J]. J Emerg Med, 2019, 56(5): 499-511.
[13] Wang XY, Zhao J, Jiao Y, et al. Upper gastrointestinal foreign bodies in adults: a systematic review[J]. Am J Emerg Med, 2021, 50: 136-141.
[14] 解道宇, 丁钟灵, 柏志香, 等. 喉镜下取咽部隐匿性异物的临床特点和治疗效果分析(附74例报告)[J]. 中国内镜杂志, 2023, 29(6): 86-90. XIE Daoyu, DING Zhongling, BAI Zhixiang, et al. Analysis of clinical characteristics and therapeutic effects of pharyngeal occult foreign body under laryngoscope(74 cases)[J]. China Journal of Endoscopy, 2023, 29(6): 86-90.
[15] Birk M, Bauerfeind P, Deprez PH, et al. Removal of foreign bodies in the upper gastrointestinal tract in adults: European Society of Gastrointestinal Endoscopy(ESGE)Clinical Guideline[J]. Endoscopy, 2016, 48(5): 489-496.
[16] Karagozian R, Gan SI. Denudation of the esophageal mucosa following ingestion of a foreign body and vinegar[J]. Endoscopy, 2010, 42(2): 99-100.
[17] Chung CH. Corrosive oesophageal injury following vinegar ingestion[J]. Hong Kong Med J, 2002, 8(5): 365-366.
[18] Libanio D, Garrido M, Jácome F, et al. Foreign body ingestion and food impaction in adults: better to scope than to wait[J]. United European Gastroenterol J, 2018, 6(7): 974-980.
[19] 褚彦君, 曾冬前, 翁永彩, 等. 颌下腺迁徙性鱼刺异物1例[J]. 中国耳鼻咽喉头颈外科, 2017, 24(5): 248. doi:10.16066/j.1672-7002.2017.05.013 CHU Yanjun, ZENG Dongqian, WENG Yongcai, et al. A case of migrating fishbone foreign body in submandibular gland[J]. Chinese Archives of Otolaryngology-Head and Neck Surgery, 2017, 24(5): 248.
[20] Chen HQ, Wu C, Zhang ZH, et al. Migratory pharyngeal foreign bodies and related complications: analysis of 20 cases[J]. Am J Otolaryngol, 2022, 43(2): 103390. doi:10.1016/j.amjoto.2022.103390.
[21] Zuluaga CP, Aluja Jaramillo F, Velásquez Castaño SA, et al. Aortic Pseudoaneurysm Secondary to Mediastinitis due to Esophageal Perforation[J]. Case Rep Radiol, 2016, 2016: 7982641. doi:10.1155/2016/7982641.
[22] Zhao XH, Lu YQ. Multiple embolisms resulted from a huge fishbone piercing the left atrium[J]. Intensive Care Med, 2014, 40(4): 621-622.
[23] 张瑾, 张辉, 丁德涛, 等. 颈深部鱼刺异物3例诊治体会及文献复习[J]. 山东大学耳鼻喉眼学报, 2023, 37(1): 56-58. ZHANG Jin, ZHANG Hui, DING Detao, et al. Diagnosis and management of fishbone foreign body in the deep neck: three case reports and literature review[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2023, 37(1): 56-58.

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