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題 名 | 食道異物=Esophageal Foreign Body |
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作 者 | 熊明旺; 王興萬; 蘇文勇; | 書刊名 | 國防醫學 |
卷 期 | 31:2 2000.08[民89.08] |
頁 次 | 頁108-111 |
專 輯 | 耳鼻喉科急症專輯 |
分類號 | 416.898 |
關鍵詞 | 食道異物; 硬式食道鏡; Esophageal foreign body; Rigid esophagoscopy; |
語 文 | 中文(Chinese) |
中文摘要 | 喉食道異物為耳鼻喉常見的急診之一。一般好發於小孩及老年人。喉異物常見於扁桃腺、舌根及下咽等處。食道異物好發位置依次為環咽縮肌下方、胃食道交界等。硬幣、雞魚鴨骨頭、玩具等為常見的異物。喉食道異物發生時,病史的詢問相當重要,對於異物吞入的時間,異物的形狀及目前的症狀可以給醫生診斷及治療的參考,症狀隨位置有極大的差異。喉及上食道異物,其症狀主要為吞嚥困難、疼痛等。隨著異物往下移,則症狀越不明顯。一般由異物引起之黏膜破損導致的疼痛在24小時內會漸漸減輕。徵象除了可直視喉部異物外,另於下咽處易有口水堆積等。對於食道異物患者,放射檢查是必需的,一般是以頸部X光為主。喉食道異物治療主要是以直接移除為主,而食道異物則必須在全身麻醉下,以硬式食道鏡為之。對於食道異物移除後,則應注意是否有嚴重黏膜損傷及食道穿孔外,一般建議患者禁食及保守治療數天不等,以利復原。 |
英文摘要 | Foreign bodies in the digestive tract can be life-threatening if not detected early. The most common esophageal foreign body in children is a coin; the second is food. In adult the more common esophageal foreign bodies are fish bones, dentures, meat, and meat bones. The most common symptom of foreign-body ingestion in adults is dysphagia, which may be accompanied by drooling, vomiting, or chest pain. Children most often have vomiting and odynophagia, although airway symptoms also are common. When ingestion of a foreign body is suspected, routine chest radiographs should be obtained. The clinician must use his best judgment based on the history, including the type of foreign body ingested, and a thorough physical examination. Anatomical areas of functional narrowing, such as the upper and lower esophageal sphincters, more commonly trap foreign bodies. Coins often are found in the postcricoid area or the esophageal inlet. Disk-shaped objects often are found in the cervical esophagus distal to the cricopharyngeus or at the inferior constrictor. In most circumstances, treatment for an esophageal foreign body is endoscopic removal under general anesthesia. Some foreign-body ingestions should be considered emergencies such as small, disk-shaped batteries and coin retained in the body for longer than 24 hours. After the uneventful removal of an esophageal foreign body, the patient can be discharged if doing well after about 12 to 24 hours of observation. |
本系統中英文摘要資訊取自各篇刊載內容。