CAJ | 학술논문

目的：了解儿童获得性气管食管瘘（TEF）保守治疗的效果。方法结合文献分析2009年6月至2012年12月2例在我院保守治疗的儿童获得性TEF临床资料及随访资料。结果2例均为女性，年龄分别为11个月和1岁1个月，均为误吞纽扣电池后出现TEF。2例患者均行胃造瘘及空肠造瘘予胃肠减压及空肠营养支持，分别经过约5个月及8个月2例患者TEF均完全愈合。以“儿童，气管食管瘘，获得性”为关键词在万方数据库检索中文文献（1982年至2012年），未见有儿童获得性TEF保守治疗的报道，以相同的关键词在Pubmed数据库检索英文文献共有37篇关于儿童获得性TEF的文献，其中仅有7篇文献报道了7例采用保守治疗。结论儿童误吞电池容易导致获得性TEF；当患者不能耐受手术且瘘口较小，特别是瘘口≤10 mm时，内科保守治疗可作为初始治疗的选择，一旦选择保守治疗应密切随访观察可能出现的并发症。
목적：료해인동획득성기관식관루（TEF）보수치료적효과。방법결합문헌분석2009년6월지2012년12월2례재아원보수치료적인동획득성TEF림상자료급수방자료。결과2례균위녀성，년령분별위11개월화1세1개월，균위오탄뉴구전지후출현TEF。2례환자균행위조루급공장조루여위장감압급공장영양지지，분별경과약5개월급8개월2례환자TEF균완전유합。이“인동，기관식관루，획득성”위관건사재만방수거고검색중문문헌（1982년지2012년），미견유인동획득성TEF보수치료적보도，이상동적관건사재Pubmed수거고검색영문문헌공유37편관우인동획득성TEF적문헌，기중부유7편문헌보도료7례채용보수치료。결론인동오탄전지용역도치획득성TEF；당환자불능내수수술차루구교소，특별시루구≤10 mm시，내과보수치료가작위초시치료적선택，일단선택보수치료응밀절수방관찰가능출현적병발증。
Objective To investigate the effect of conservative management of acquired tracheoesophageal fistula (TEF) in children. Methods A retrospective analysis was conducted on the hospitalized patients with acquired TEF from June 2009 to December 2012 in the Respiratory Medicine, Guangzhou Institute of Respiratory Disease and literatures. Results Two female patients aged 13 months, 11 months respectively. Acquired TEF may occur secondary to an ingested button battery impacted in the oesophagus. Gastrostomy and jejunostomy were performed as the preliminary interventions. About five and eight months of expectant management revealed spontaneous closure of the TEF by radiographic evaluation. No Chinese article related with acquired TEF in children were found after searching with the key words“child;tracheoesophageal fistula;acquired”in“Wanfang”database (1982-2012). Search with the same key words in“Pubmed”showed that only seven articles with seven cases of acquired TEF treated by conservative management were reported. Conclusion TEF could easily occur after an ingested disc battery impacted in the oesophagus in children. Conservative management is recommended to be the choice for acquired TEF in children, especially when the conditions is not proper for surgery or addressing TEF no more than 10 mm in length. Close follow-up is necessary if conservative management is utilized.