安大略省儿童纽扣电池撞击管理的及时性:一项多中心分析。

IF 2
CJEM Pub Date : 2025-09-17 DOI:10.1007/s43678-025-01010-4
Nikolaus E Wolter, Jennifer M Siu, Jacob Davidson, Ayushi Bhatt, Olivia Ostrow, Ryan Rourke, Xinyuan Hong, Jonathan Maclean, Jakob Pugi, Kristina H Pulkki, Justine G Philteos, M Elise Graham, Natashia M Seemann
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引用次数: 0

摘要

导读:食道钮扣电池撞击是危及儿童生命的医疗紧急情况。有既定的临床基准来帮助减少受伤的风险。我们的目的是描述安大略省四个主要儿科中心出现食管纽扣电池撞击的儿童的护理途径。方法:对4家大型三级儿科医院2012 - 2023年儿童纽扣电池误食病例进行多机构健康记录回顾。参与者包括18岁以下的儿童,他们接受了食管镜检查以取出电池。结果:共发现86例钮扣电池嵌塞儿童。中位年龄为2.6岁。15名儿童直接被送到高等教育机构,71名儿童(82.6%)从社区医院转来。总行驶距离中位数为44.6公里。从钮扣电池诊断到取出的中位时间为7.9小时。结论:尽管努力提高对钮扣电池摄入的认识和快速管理,但明显的延迟,对缓解策略的依从性差,严重的并发症持续存在。这些发现强调需要预防和制定针对区域和机构的方案,以提供及时和精简的护理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Timeliness of management of button battery impactions in children in the province of Ontario: a multi-center analysis.

Introduction: Esophageal button battery impactions represent a life-threatening medical emergency in children. There are established clinical benchmarks to help reduce the risk of injury. Our objective was to describe the care pathways of children presenting with esophageal button battery impactions in the four main pediatric centers in Ontario.

Methods: A multi-institutional health records review of button battery ingestion cases in children from 2012 to 2023 at four large-volume tertiary pediatric hospitals was conducted. Participants included children under 18 years who underwent esophagoscopy for battery removal.

Results: Eighty-six children with button battery impactions were identified. The median age was 2.6 years. Fifteen children presented directly to a tertiary institution, while 71 (82.6%) were transferred from a community hospital. The median total distance traveled was 44.6 km. The median time from button battery diagnosis to removal was 7.9 h. Honey or sucralfate was administered in < 5% of cases. The median hospital stay was 3.1 days. Complications included esophageal perforation (2.3%), esophageal stricture (8.5%), tracheoesophageal fistula (1.2%), and vascular injury (1.2%), with one death reported. No cases met the benchmark of button battery removal within 2 h of ingestion, with significant delays occurring at every management stage.

Conclusion: Despite efforts to increase awareness and rapid management of button battery ingestion, significant delays, poor adherence to mitigation strategies, and serious complications persist. These findings emphasize the need for prevention and the development of regional and institution-specific protocols to provide timely and streamlined care.

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