腹腔镜辅助手术与开腹手术治疗儿童消化道磁性异物的效果比较

doi:10.20047/j.issn1673-7210.2022.35.21

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摘要目的比较腹腔镜辅助手术与开腹手术治疗儿童消化道磁性异物的效果。方法选取2015年12月至2022年1月首都医科大学附属北京儿童医院收治并进行手术治疗的消化道磁性异物患儿84例。依据手术方式不同，将患儿分为开腹组（42例）、腹腔镜组（30例），余12例腹腔镜中转开腹的患儿未被纳入分组。比较两组磁性异物数量、磁性异物分布位置、磁性异物所致并发症情况、手术时间、术中出血量、术后进食时间、术后住院时间、术后并发症情况。结果两组消化道磁性异物分布在空回肠的例数比较，差异有统计学意义（P＜0.05）。两组术前肠梗阻发生率、异物导致消化道穿孔发生率、消化道穿孔数量、内疝发生率比较，差异无统计学意义（P＞0.05）。两组手术时间比较，差异有统计学意义（P＜0.05）；两组术中出血量、术后进食时间、术后住院时间比较，差异无统计学意义（P＞0.05）。两组术后并发症总发生率比较，差异无统计学意义（P＞0.05）。两组住院费用比较，差异有统计学意义（P＜0.05）。结论腹腔镜辅助手术在小儿消化道磁性异物的治疗上与开腹手术疗效相当，术者需根据具体情况选择相应的手术方式。

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	陈龙王大勇张潍平刘婷婷沈秋龙王丽谢方南李现令

关键词 ：儿童, 磁性异物, 腹腔镜, 手术

Abstract：Objective To compare the effect of laparoscopic-assisted surgery and open laparotomy in the treatment magnetic foreign body in children’s digestive tract. Methods From December 2015 to January 2022, 84 patients with magnetic foreign bodies in digestive tract undergoing surgical treatment admitted Beijing Children’s Hospital, Capital Medical University were selected, and they were divided into open laparotomy group (42 cases), laparoscopic group (30 cases) according to the surgical method, and the remaining twelve child patients who were converted from laparoscopy to laparotomy were not included in the group. The number of magnetic foreign bodies, distribution of the magnetic foreign bodies, complications caused by magnetic foreign bodies, operation time, intraoperative blood loss, postoperative feeding time, postoperative hospitalization time, and postoperative complications were compared between two groups. Results There was statistical significance in the number of magnetic foreign bodies in empty ileum between two groups (P＜0.05). There were no significant differences in the incidence of preoperative intestinal obstruction, the incidence of digestive tract perforation caused by magnetic foreign bodies, the number of digestive tract perforation, and the incidence of internal hernia between two groups (P＞0.05). The operation time between two groups was statistically significant (P＜0.05); there were no significant differences in intraoperative blood loss, postoperative feeding time, and postoperative hospitalization time between two groups (P＞0.05). There was no significant difference in the total incidence of postoperative complications between two groups (P＞0.05). The hospitalization expenses of two groups were compared, and the difference was statistically significant (P＜0.05). Conclusion Laparoscopic-assisted surgery has the same efficacy as open laparotomy in the treatment of magnetic foreign bodies in children’s digestive tract. The surgeon should choose the appropriate surgical methods according to the specific conditions.

Key words： Child Magnetic foreign body Laparoscopy Surgery

基金资助:北京市医院管理局临床医学发展专项—“扬帆”计划项目（ZYLX201709）。

通讯作者: 李现令（1978.2-），男，博士，副主任医师；研究方向：小儿急诊外科学。

作者简介: 陈龙（1987.11-），男，硕士，主要从事小儿急诊外科工作。

引用本文:

陈龙王大勇张潍平刘婷婷沈秋龙王丽谢方南李现令. 腹腔镜辅助手术与开腹手术治疗儿童消化道磁性异物的效果比较[J]. 中国医药导报, 2022, 19(35): 92-95.
CHEN Long WANG Dayong ZHANG Weiping LIU Tingting SHEN Qiulong WANG Li XIE Fangnan LI Xianling. Effect comparison of laparoscopic-assisted surgery and open laparotomy in the treatment of magnetic foreign body in children’s digestive tract. 中国医药导报, 2022, 19(35): 92-95.

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[1] Wang K，Zhang D，Li XL，et al. Multicenter investigation of pediatric gastrointestinal tract magnets ingestion in China [J]. BMC Pediatr，2020，20（1）：95.
[2] Zheng Y，Zhang Z，Yan K，et al. Retrospective analysis of pediatric patients with multiple rare-earth magnets ingestion：a single-center experience from China [J]. BMC Pediatr，2021，21（1）：179.
[3] Thakkar H，Burnand KM，Healy C，et al. Foreign body ingestion in children：a magnet epidemic within a pandemic [J]. Arch Dis Child，2021，106（12）：1240-1241.
[4] van Waas M，De Bruyne P，de Ridder L. Paediatric multiple magnet ingestion [J]. Lancet Gastroenterol Hepatol，2021，6（1）：80.
[5] Price J，Malakounides G，Stibbards S，et al. Ball magnet ingestion in children：a stronger and more dangerous attraction？[J]. Emerg Med J，2022，39（6）：467-470.
[6] Alfonzo MJ，Baum CR. Magnetic Foreign Body Ingestions [J]. Pediatr Emerg Care，2016，32（10）：698-702.
[7] Miyamoto R，Okuda M，Kaneko K，et al. Multiple Magnets Ingestion Followed by Intestinal Fistula With Mild Symptoms [J]. Glob Pediatr Health，2019，6：2333794X19855805.
[8] Stephenson SG，Knight CT，Rana HN，et al. An Unfortunate Union：A Case of Multiple Magnet Ingestion in a Pediatric Patient [J]. Cureus，2022，14（1）：e21490.
[9] Zhang S，Zhang L，Chen Q，et al. Management of magnetic foreign body ingestion in children [J]. Medicine（Baltimore），2021，100（2）：e24055.
[10] Li XL，Zhang QM，Lu SY，et al. Clinical report and analysis of 24 cases of multiple magnetic beads foreign body in gastrointestinal tract of children [J]. Turk J Gastroenterol，2020，31（11）：819-824.
[11] Sola R Jr，Rosenfeld EH，Yu YR，et al. Magnet foreign body ingestion：rare occurrence but big consequences [J]. J Pediatr Surg，2018，53（9）：1815-1819.
[12] Orsagh-Yentis D，McAdams RJ，Roberts KJ，et al. Foreign- Body Ingestions of Young Children Treated in US Emergency Departments：1995-2015 [J]. Pediatrics，2019，143（5）：e20181988.
[13] Olczak M，Skrzypek E. A case of child death caused by intestinal volvulus following magnetic toy ingestion [J]. Leg Med（Tokyo），2015，17（3）：184-187.
[14] Waters AM，Teitelbaum DH，Thorne V，et al. Surgical management and morbidity of pediatric magnet ingestions [J]. J Surg Res，2015，199（1）：137-140.
[15] De Roo AC，Thompson MC，Chounthirath T，et al. Rareearth magnet ingestion-related injuries among children，2000- 2012 [J]. Clin Pediatr（Phila），2013，52（11）：1006-1013.
[16] Abbas MI，Oliva-Hemker M，Choi J，et al. Magnet ingestions in children presenting to US emergency departments，2002-2011 [J]. J Pediatr Gastroenterol Nutr，2013，57（1）：18-22.
[17] 中华医学会消化内镜学分会.中国上消化道异物内镜处理专家共识意见（2015年，上海）[J].中华消化内镜杂志，2016，33（1）：19-28.
[18] 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.
[19] 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.
[20] Lyu X，Pi Z，Wang Z，et al. Successful removal of multiple magnetic foreign bodies in the digestive tract of children by gastroscopy：Two case reports [J]. Medicine，2019，98（18）：e15435.
[21] Lee HJ，Kim HS，Jeon J，et al. Endoscopic foreign body removal in the upper gastrointestinal tract：risk factors predicting conversion to surgery [J]. Surg Endosc，2016，30（1）：106-113.
[22] Zhang YB，Gao ZG，Xiong QX，et al. Clinical experience in the treatment of children who swallowed multiple magnetic foreign bodies：A report of five cases [J]. World J Pediatr，2017，13（3）：274-277.
[23] Hodges NL，Denny SA，Smith GA. Rare-Earth Magnet Ingestion-Related Injuries in the Pediatric Population：A Review [J]. Am J Lifestyle Med，2015，11（3）：259-263.
[24] Ding G，Liu H，Zhou P，et al. Pediatric Multiple High-Powered Magnetic Buckyballs Ingestion-Experience From Six Tertiary Medical Centers [J]. Front Public Health，2022， 10：892756.
[25] 黄华，崔晓燕，张大，等.完全腹腔镜手术治疗小儿消化道异物磁力珠10例分析[J].中国微创外科杂志，2021， 21（7）：657-660.
[26] 刘翠苹，杨军，张伟同，等.腹腔镜与传统开腹手术治疗小儿消化道磁性异物的对比研究[J].临床外科杂志，2022，30（5）：483-485.
[27] Huang X，Hu J，Xia Z，et al. Multiple magnetic foreign body ingestion in pediatric patients：a single-center retrospective review [J]. Pediatr Surg Int，2021，37（5）：639-643.