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摘要


背景:上呼吸消化道異物為耳鼻喉科急診常見求診問題,本院每年約有1,000名病患誤食異物至急診求診。本研究主要分析誤食異物之病患組成、異物種類、處置方式及移除異物的位置,並回顧發生併發症而住院的案例。方法:回溯病歷從2015年7月至2015年12月,共6個月間,主訴誤食異物而至本院急診就醫的病患,回顧其就診檢查的結果。結果:回溯病歷共計515例,有24例(4.7%)高度懷疑誤食異物,但是拒絶進一步檢查確診,236例(45.8%)無明顯證據發現異物,且其平均年紀也較移除及高度懷疑誤食異物個案年輕(p<0.05),255例(49.5%)順利移除異物,其中男性有137例(53.7%)、女性有118例(46.3%),以232例魚刺(91%)為最常見異物,異物移除部位依次為舌根及其他口咽部、扁桃腺、食道、下咽及喉部,扁桃腺異物以年輕個案為主(p<0.0001),食道異物以女性(p<0.05)及較年長個案為主要分佈,有5例(0.97%)因誤食異物而產生相關併發症,包括急性會厭炎、肺炎、食道穿孔各1例及食道黏膜糜爛2例。結論:上呼吸消化道誤食異物病例,約有一半個案在檢查後會發現異物,最常見異物位置依次為舌根及其他口咽部、扁桃腺及食道。小於15歲患者中,異物分佈於扁桃腺機會最高;而食道及下咽異物比率在女性及中老年族群較高。當異物位於食道時,往往需要安排上消化道内視鏡或硬式食道鏡檢查取出,更需留意相關可能的併發症。

並列摘要


BACKGROUND: Foreign body mis-swallowing is a common otorhinolaryngological emergency event. The study aimed to explore the clinical correlation of upper aerodigestive tract (UADT) foreign body ingestion (FBI). METHODS: The medical records of 515 patients who visited the National Cheng Kung University Hospital Emergency Department with UADT foreign body ingestion during July, 2015 to December, 2015 were retrospectively reviewed. Data on age, examinations, foreign body types, UADT subsites, removal methods and complications were collected. RESULTS: Among the 515 patients, 24 (4.7%) were highly suspicious for FBI but refused further management, 236 (45.8%) had no evidence of FBI. The average age of patients without evidence of FBI was significantly younger than that of patients who were highly suspicious of FBI or underwent foreign body (FB) removal (p < 0.05). Two hundred fifty-five patients (49.5%) had FB removed. There were 137 males (53.7%) and 118 females (46.3%) and fish bone was the most common type of FB. The most common location of the foreign bodies was tongue base followed by tonsil, esophagus, hypopharynx, and larynx. The average age of patients with tonsillar FB was significantly younger than that of patients with FB at the other UADT subsites (p < 0.0001). More female and older age cases had hypopharyngeal or esophageal FBI. Five patients (0.97%) had serious complications correlated due to FBI or corresponding medical procedures but recovered without sequelae. CONCLUSION: About half of the UADT FBI patients had FB removed and the most common UADT location was tongue base, tonsil, and esophagus. FBI-related complications were less common but needed meticulous consideration.

延伸閱讀


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