山东大学耳鼻喉眼学报 ›› 2023, Vol. 37 ›› Issue (1): 56-58.doi: 10.6040/j.issn.1673-3770.0.2021.440

• 论著 • 上一篇    下一篇

颈深部鱼刺异物3例诊治体会及文献复习

张瑾1,张辉2,丁德涛2,张永红2,李笑颖1,索安奇1,李晓瑜2,吴允刚2   

  1. 1. 济宁医学院 临床医学院, 山东 济宁 272013;
    2. 济宁医学院附属医院 耳鼻咽喉头颈外科, 山东 济宁 272029
  • 发布日期:2023-02-06
  • 通讯作者: 吴允刚. E-mail:wyg0607@163.com
  • 基金资助:
    济宁市科技局重点研发项目(2021YXNS028,2021YXNS048,2021YXNS052);贺林院士新医学临床转化工作站科研基金项目(JYHL2022FMS11);济宁医学院附属医院主治医师团队专项研究计划(ZZTD-2022-007)

Diagnosis and management of fishbone foreign body in the deep neck: three case reports and literature review

ZHANG Jin1, ZHANG Hui2, DING Detao2, ZHANG Yonghong2, LI Xiaoying1, SUO Anqi1, LI Xiaoyu2, WU Yungang2   

  1. 1. Clinical Medical College, Jining Medical University, Jining 272013, Shandong, China;
    2. Departments of Otorhinolaryngology & Head and Neck Surgery, Affiliated Hospital of Jining Medical University, Jining 272029, Shandong, China
  • Published:2023-02-06

摘要: 目的 探讨颈深部鱼刺异物的临床表现、诊断及手术方式体会。 方法 回顾性分析3例颈深部鱼刺异物患者的病例资料,并复习相关文献,总结其诊断及治疗方法。 结果 鱼刺是上消化道最常见的异物之一,咽、食管异物是耳鼻咽喉科最常见的急诊。尖锐异物或者停留时间长的异物常可引起咽部及食管黏膜损伤,继发感染,若诊治不当或处理不及时,可导致严重并发症,因此尽早取出异物非常重要。 结论 警惕鱼刺异物进入颈深部软组织内的可能性,选用合适的影像学方法进行确诊和定位,手术为首选治疗方式。

关键词: 颈深部, 食管, 甲状腺, 鱼刺异物

Abstract: Objective To investigate the clinical manifestation, diagnosis, treatment, and operation of fishbone foreign body in deep neck. Methods A retrospective review of three patients who were treated for a fishbone foreign body in the deep neck. The relevant literature were reviewed to summarize their diagnosis and treatment experiences. Results A fishbone is one of the most common foreign bodies found in the upper gastrointestinal tract. Pharyngeal and esophageal foreign bodies are the most common emergency in the otorhinolaryngology(ear nose and throat(ENT))department. Sharp foreign bodies or foreign bodies with long residence time can often cause pharyngeal and esophageal mucosal damage and secondary infection. If they are not treated properly or not treated in time, foreign bodies can lead to serious complications. Therefore, it is very important to remove the foreign bodies as soon as possible. Conclusion We must be alert to the possibility of a fishbone foreign body entering the deep soft tissue of the neck, and appropriate imaging methods for the diagnosis and location of the foreign body must be selected. Surgery is the first choice of treatment for removing the fishbone foreign body.

Key words: Deep neck, Esophagus, Thyroid, Fishbone foreign body

中图分类号: 

  • R768
[1] 王耀文, 张媛媛, 顾亚军, 等. 咽喉部鱼刺异物迁移致颈部脓肿分析[J]. 中国耳鼻咽喉头颈外科, 2016, 23(12): 716-718. doi:10.16066/j.1672-7002.2016.12.010 WANG Yaowen, ZHANG Yuanyuan, GU Yajun, et al. Neck abscess caused by foreign body of fish bone in pharynx[J]. Chinese Archives of Otolaryngology-Head and Neck Surgery, 2016, 23(12): 716-718. doi:10.16066/j.1672-7002.2016.12.010
[2] 董锦锦, 田秀芬. 664例食管异物患者临床诊治分析[J]. 临床耳鼻咽喉头颈外科杂志, 2017, 31(8): 639-640. doi:10.13201/j.issn.1001-1781.2017.08.017 DONG Jinjin, TIAN Xiufen. Clinical diagnosis and treatment for esophageal foreign body in 665 cases[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2017, 31(8): 639-640. doi:10.13201/j.issn.1001-1781.2017.08.017
[3] Nandi P, Ong GB. Foreign body in the oesophagus: review of 2394 cases[J]. Br J Surg, 1978, 65(1): 5-9. doi:10.1002/bjs.1800650103
[4] Yuan JJ, Ma MJ, Guo Y, et al. Delayed endoscopic removal of sharp foreign body in the esophagus increased clinical complications: an experience from multiple centers in China[J]. Medicine, 2019, 98(26): e16146. doi:10.1097/MD.0000000000016146
[5] Ashraf O. Foreign body in the esophagus: a review[J]. Sao Paulo Med J, 2006, 124(6): 346-349. doi:10.1590/s1516-31802006000600010
[6] 李文, 甘雪琦, 陈哲, 等. 鱼刺异物致颈部脓肿1例[J]. 临床耳鼻咽喉头颈外科杂志, 2010, 24(3): 139-140. doi:10.3969/j.issn.1001-1781.2010.03.015
[7] 王艳红, 吴圆圆, 牛家增. 超声诊断甲状腺内鱼刺异物1例[J]. 中国临床医学影像杂志, 2014, 25(1): 69-70 WANG Yanhong, WU Yuanyuan, NIU Jiazeng. Fish bone foreign body within thyroid gland diagnosed by ultrasound: report of one case[J]. Journal of China Clinic Medical Imaging, 2014, 25(1): 69-70
[8] Petrarolha SMP, Dedivitis RA, Perruccio FG, et al. Esophagus foreign body in the thyroid gland[J]. Braz J Otorhinolaryngol, 2020, 86(Suppl 1): 64-66. doi:10.1016/j.bjorl.2017.08.008
[9] 叶凡, 陈建福, 吴贤敏, 等. 消化道腔外鱼刺致耳鼻咽喉并发症的临床分析[J]. 温州医科大学学报, 2016, 46(12): 919-922, 926. doi:10.3969/j.issn.2095-9400.2016.12.015 YE Fan, CHEN Jianfu, WU Xianmin, et al. A clinical analysis of otorhinolaryngologic complications induced by ifsh bone[J]. Journal of Wenzhou Medical University, 2016, 46(12): 919-922, 926. doi:10.3969/j.issn.2095-9400.2016.12.015
[10] 倪茂杰, 刘学, 蒋迪. 超声诊断颈部迁徙性鱼刺异物2例[J]. 中国医学影像技术, 2020, 36(4): 518. doi:10.13929/j.issn.1003-3289.2020.04.009 NI Maojie, LIU Xue, JIANG Di. Ultrasonic diagnosis of migrating fish bone in the neck: report of 2 cases[J]. Chinese Journal of Medical Imaging Technology, 2020, 36(4): 518. doi:10.13929/j.issn.1003-3289.2020.04.009
[11] Woo SH, Kim KH. Proposal for methods of diagnosis of fish bone foreign body in the Esophagus[J]. Laryngoscope, 2015, 125(11): 2472-2475. doi:10.1002/lary.25340
[12] Yang SW, Chen TM, Chen TA. Migrating fish bone complicating a deep neck abscess[J]. Chang Gung Med J, 2005, 28(12): 872-875
[13] 古庆家, 樊建刚, 李静娴, 等. 食管异物并发食管穿孔及颈部脓肿临床分析[J]. 临床耳鼻咽喉头颈外科杂志, 2014, 28(7): 459-461. doi:10.13201/j.issn.1001-1781.2014.07.008 GU Qingjia, FAN Jiangang, LI Jingxian, et al. Clinical analysis of esophageal perforation and neck abscess induced by esophageal foreign body[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2014, 28(7): 459-461. doi:10.13201/j.issn.1001-1781.2014.07.008
[14] 欧阳天斌, 王耀文, 唐世雄, 等. 咽喉部鱼刺迁移致颈部26例临床分析[J]. 现代实用医学, 2021, 33(6): 787-788. doi:10.3969/j.issn.1671-0800.2021.06.040
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