七年制醫(yī)學(xué)課件耳鼻喉7食管異物

ForeignBodyintheEsophagus食管異物

重慶醫(yī)科大學(xué)附屬第一醫(yī)院耳鼻喉科陳鴻雁

ForeignBodyintheEsophagus食11、Anatomy4physiologicalnarrows(4個生理性狹窄)Theentranceoftheesophagus（食道入口）Abouttheleverof4ththoraticvertebra(第4胸椎)Abouttheleverof5ththoraticvertebra

(第5胸椎)Abouttheleverof10ththoraticvertebra

(第10胸椎)1、Anatomy4physiological2七年制醫(yī)學(xué)課件耳鼻喉7食管異物3七年制醫(yī)學(xué)課件耳鼻喉7食管異物42、Etiology(病因?qū)W)(1)Commoninchildrenandtheelders（老人和兒童常見）(2)Diseasesoftheesophogusitself（食道本身病變）(3)Foreignbodymostlylocatedinthefirstnarrow（第一狹窄常見）(4)Animalforeignbodiesareoftenfound（動物性異物常見）2、Etiology(病因?qū)W)(1)Commoninc5Entranceofesophagus（食道入口）Entranceofesophagus（食道入口）63、ClinicalAppearance（臨床表現(xiàn)）(1)

Dysphagia(吞咽困難)(2)

Dynphagiaorodynophagia(吞咽疼痛)(3)

Symptomsofrespiratorysystem

(呼吸道癥狀)Dyspnea(呼吸困難)Apnea（窒息）

(4)limittedactivityoftheneck

頸部活動受限(5)highfever

發(fā)熱

(6)inflammationofesophagus

食道穿破感染3、ClinicalAppearance（臨床表現(xiàn)）(1)74、Diagnosis(診斷)(1)Thehistoryofswallowsth.(誤吞異物史)(2)Clinicalsymptoms(臨床癥狀)(3)PE（physicalexamination）（體格檢查）4、Diagnosis(診斷)(1)Thehistory8(4)X-ray:A、Metallicforeignbodies（金屬異物）-----easilyB、fishbone.meat(duckchicken)bone（動物骨肉）-------difficultawispofbariumcottonmaybehelpful（鋇棉透視）(4)X-ray:9(5)Esophagoscopy（食管鏡檢查）

ToexaminetheesophagusTotakeouttheforeignbodies

(5)Esophagoscopy（食管鏡檢查）

Toex10七年制醫(yī)學(xué)課件耳鼻喉7食管異物11七年制醫(yī)學(xué)課件耳鼻喉7食管異物12TheupperrimofthecoinisjustvisibleinthepostcricoidregionTheupperrimofthecoinisj13七年制醫(yī)學(xué)課件耳鼻喉7食管異物14七年制醫(yī)學(xué)課件耳鼻喉7食管異物15Foreignbody,toykey,incervicalesophagusForeignbody,toykey,incerv16Foreignbody,cervicalesophagusForeignbody,cervicalesophag17七年制醫(yī)學(xué)課件耳鼻喉7食管異物18七年制醫(yī)學(xué)課件耳鼻喉7食管異物195、Complication（并發(fā)癥）(1)Perforationorinflamationoftheesophagus(食管穿孔或食道炎癥)(2)AerodermectasiaorPneumohypoderma

（皮下氣腫）(3)Periesophagitisormediastinitis

(食管周圍炎或縱隔炎)(4)Breaking-outofgreatbloodvessel

(血管破潰)(5)Tracheo-esophagealfistula

(氣管食管瘺)5、Complication（并發(fā)癥）(1)Perfora206、Treatment(治療)（1）Removaloftheforeignbody（異物取出術(shù)）usuallyrigidesophagoscopy（通常用硬管）(2)Internaltreatment