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目的了解儿童获得性气管食管瘘(TEF)保守治疗的效果。方法结合文献分析2009年6月至2012年12月2例在我院保守治疗的儿童获得性TEF临床资料及随访资料。结果 2例均为女性,年龄分别为11个月和1岁1个月,均为误吞纽扣电池后出现TEF。2例患者均行胃造瘘及空肠造瘘予胃肠减压及空肠营养支持,分别经过约5个月及8个月2例患者TEF均完全愈合。以“儿童,气管食管瘘,获得性”为关键词在万方数据库检索中文文献(1982年至2012年),未见有儿童获得性TEF保守治疗的报道,以相同的关键词在Pubmed数据库检索英文文献共有37篇关于儿童获得性TEF的文献,其中仅有7篇文献报道了7例采用保守治疗。结论儿童误吞电池容易导致获得性TEF;当患者不能耐受手术且瘘口较小,特别是瘘口≤10 mm时,内科保守治疗可作为初始治疗的选择,一旦选择保守治疗应密切随访观察可能出现的并发症。
Objective To understand the effect of conservative treatment of childhood acquired tracheal esophageal fistula (TEF). Methods Combined with literature analysis of 2 cases of conservative treatment of pediatric acquired TEF in our hospital from June 2009 to December 2012 clinical data and follow-up data. Results Both of the two cases were female, with the age of 11 months and 1 year and 1 month, respectively. All of them were TEF after swallowing the button cell. Gastrostomy and jejunostomy were performed in 2 patients with gastrointestinal decompression and jejunal nutrition support. TEF of 2 patients were completely healed after about 5 months and 8 months respectively. There were no reports of conservative treatment of children with acquired TEF in the Chinese literature (1982-2012) using the keywords “children, tracheoesophageal fistula, acquired” as the key words in the Wanfang database, with the same key words in Pubmed A total of 37 articles on children’s acquired TEF were searched in the database. Only 7 articles reported conservative treatment in 7 cases. Conclusions Child-swallowed cells can easily lead to acquired TEF. Conservative medical treatment can be used as initial treatment when the patient can not tolerate surgery and the fistula is small, especially when the fistula is less than or equal to 10 mm. Once the conservative treatment is selected, close follow-up observation Possible complications.