Objective To present novel measures in endoscopic removal of foreign bodies in the upper gastrointestinal tract. Methods The clinical trial performed a retrospective analysis of emergency endoscopic management of 251 cases of foreign bodies in the upper gastrointestinal tract from January 2013 to November 2016. The patients underwent gastric endoscopic examinations under local pharyngeal anesthesia or general intravenous anesthesia. Flexible endoscopes and retrieval accessories such as rat-tooth and alligator forceps, polyp snares, polyp graspers, dormia basket, lithotripter or grasping forceps or rubber gloves were used for the endoscopic procedures. We reviewed of patients' general data (age, sex, type of foreign body), type of anaesthesia, foreign bodies' locations, type of accessory, complications, success rate. Results A total of 251 foreign bodies were definitely diagnosed through endoscopy, 248 foreign bodies were successfully removed with compatible devices according to the foreign bodies' location, nature, and size, and 3 cases failed. At the same time, 192 cases had little mucosal laceration and bleeding, and 45 cases were found to have underlying diseases. 1cases had esophageal surgery and 1cases had laryngeal surgery. 1 cases refuse to remove the foreign body because no symptoms and therapheutic risks. Conclusion Emergency endoscopic management is the foremost option for foreign bodies in the upper gastrointestinal tract, for its obvious advantages in safety, efficiency, low cost, and minimal invasion. Endoscopic intervention can also diagnose early underlying digestive diseases. Innovative measures can increase the successful rate of removing foreign bodies with gastric endoscopy.%目的 展示急诊内镜下上消化道异物取出术的经验及创新的措施.方法 该研究回顾性分析2013年1月-2016年11月在该院消化内镜室取出异物的251例患者,患者采取局部麻醉或静脉复合麻醉方法,应用软式内镜和各种内镜附件(鼠齿钳、鳄鱼钳、息肉勒除器、息肉抓钳、取石网篮、碎石器或者碎石工具套装和橡胶手套等)进行诊治.收集患者的一般资料(年龄、性别、异物类型)、麻醉种类、异物崁顿的位置、内镜附件的类型、并发症和成功率.结果 251例患者均通过内镜确诊为消化道异物,248例患者异物被成功取出,3例失败,其中1例患者行胸外科手术,1例行耳鼻喉科手术,1例患者因为没有症状和治疗风险而拒绝行异物取出术.192例有轻微黏膜损伤或出血,45例患者发现潜在疾病.结论 急诊内镜下异物取出术是治疗消化道异物的最佳手段,因为其在安全性、有效性、费用低、微创方面有绝对优势,而且内镜治疗时还可以发现潜在消化系统疾病;创新性的手段可提高异物取出成功率.
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