耳、鼻、喉异物。

IF 3.5 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL
American family physician Pub Date : 2025-07-01
J Lane Wilson
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引用次数: 0

摘要

耳朵、鼻子和喉咙里的异物在幼儿中很常见,也可能发生在其他人群中。耳内异物(即外耳道)患者通常无症状,但可表现为耳痛、充盈感、听觉减退、瘙痒和耳漏(通常为出血)。根据物体的类型和嵌塞的程度,可以尝试在办公室内配合或适当限制有冲洗或器械的患者。同样,鼻腔异物通常可以在办公室使用正压技术安全地移除,当物体可见时,再使用仪器。已经描述了广泛的工具和方法,但缺乏证据来推荐具体的工具或技术。对于外耳道异物或鼻异物清除困难或危险较大的患者,如患者不能安全固定,物体穿透或纽扣电池,或清除尝试失败时,建议转诊。咽喉异物对气道构成重大而直接的危险,需要紧急处理。所有气道异物患者应转至急诊科镇静,通过柔性或刚性内窥镜直接观察异物,并取出。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Foreign Bodies in the Ear, Nose, and Throat.

Foreign bodies in the ear, nose, and throat are common in young children and can also occur in other populations. Patients with foreign bodies in the ear (ie, external auditory canal) are usually asymptomatic but can present with otalgia, sensation of fullness, hypoacusis, pruritus, and otorrhea (usually bleeding). Removal in the office may be attempted in cooperative or appropriately restrained patients with irrigation or instrumentation, depending on the type of object and degree of impaction. Similarly, nasal foreign bodies can often be removed safely in the office with positive pressure techniques followed by instrumentation when the object is visible. A wide range of tools and methods have been described, yet evidence is lacking to recommend specific instruments or techniques. Referral is indicated for patients with external auditory canal or nasal foreign bodies that are more difficult or dangerous to remove, such as when the patient cannot be safely immobilized, the object is penetrating or a button battery, or removal attempts have failed. Foreign bodies of the throat pose significant and immediate risks to the airway and require urgent emergency management. All patients with airway foreign bodies should be referred to the emergency department for sedation, direct visualization of the object via flexible or rigid endoscope, and removal.

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来源期刊
American family physician
American family physician 医学-医学:内科
CiteScore
2.80
自引率
2.50%
发文量
368
审稿时长
4-8 weeks
期刊介绍: American Family Physician is a semimonthly, editorially independent, peer-reviewed journal of the American Academy of Family Physicians. AFP’s chief objective is to provide high-quality continuing medical education for more than 190,000 family physicians and other primary care clinicians. The editors prefer original articles from experienced clinicians who write succinct, evidence-based, authoritative clinical reviews that will assist family physicians in patient care. AFP considers only manuscripts that are original, have not been published previously, and are not under consideration for publication elsewhere. Articles that demonstrate a family medicine perspective on and approach to a common clinical condition are particularly desirable.
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