钮扣电池致儿童食管烧伤并发症的治疗效果

A. Razumovskij, V. O. Teplov, N. Stepanenko, N. Kulikova, A. V. Adler
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摘要

的目标。目的:提高儿童食管烧伤并发症的治疗效果。材料与方法。我们分析了2009年至2021年在莫斯科卫生部N.F. Filatov儿童城市医院接受治疗的102例因磁盘电池导致的食管烧伤患者的治疗结果。发生并发症的患儿(n=57)根据采取的治疗策略分为保守治疗(n=36,占63.2%)和根治性手术(n=21,占36.8%)。结果和讨论。气管食管瘘(TEF) (n=31)的手术干预类型包括腹腔镜下吻合胃造口(38.7%)、TEF分离(41.9%)和气管整形手术加食管瓣切除(19.4%)。对腹腔镜下盆底吻合和胃造口术后TEF结果的评估显示,63.6%的病例自发闭合。到关闭的平均时间为5个月。在24例食管狭窄患儿中,95.8%的患者行了食管修补术。所有确诊为食管穿孔的患儿(n=4)均成功接受保守治疗。治疗喉瘫或喉麻痹的策略包括保守治疗和观察(33.3%),气管切开术(29.2%)和侧化手术(37.5%)。保守策略在所有并发症中表现出优越的效果,最大限度地减少了术后并发症的数量(16.7%),并确保了良好的长期预后。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Results of treatment of children with complications after burns of the esophagus from button batteries
Aim. To enhance the treatment outcomes in children with complications following an esophageal burn caused by a disk battery.Materials and Methods. We analyzed the treatment outcomes of 102 patients suffering from esophageal burns from a disk battery, who were treated at the N.F. Filatov Children’s City Hospital of the Moscow Healthcare Ministry from 2009 to 2021. Children who developed complications (n=57) were divided according to the treatment strategy employed: conservative tactics (n=36, 63.2%) and radical surgery (n=21, 36.8%).Results and Discussion. The types of surgical interventions carried out for tracheoesophageal fistula (TEF) (n=31) included laparoscopic fundoplication and gastrostomy (38.7%), separation of TEF (41.9%), and tracheal plastic surgery with an esophageal flap and extirpation of the esophagus (19.4%). Assessment of the outcomes of TEF post laparoscopic fundoplication and gastrostomy demonstrated spontaneous closure in 63.6% of the cases. The average time until closure was 5 months. Among children with esophageal stenosis (n=24), esophageal bougienage was performed in 95.8% of the cases. All children identified with esophageal perforation (n=4) were successfully treated conservatively. Tactics for managing laryngeal paresis or paralysis included conservative therapy and observation in 33.3% of cases, tracheostomy in 29.2%, and lateralization procedures in 37.5%.Conclusion. Conservative tactics demonstrated superior results in all complications, minimizing the number of postoperative complications (16.7%) and ensuring favorable long-term outcomes.
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