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Old 04-27-2011, 08:47 PM   #1
hijordan41
 
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Default 排骨卡住食道引发男子胸痛

  晨报讯(杨欢 记者王琳) 过年了,难免大鱼大肉,可吃得再香您也得慢点儿,这不,一位先生叫排骨卡住食道都不知道,差点 丢了性命。

  1月22日19时,来自山东日照的李先生因胸痛原因待查急诊入住大连市友谊医院心内科,由于心电图检查 没有发现异常,当班医生考虑李先生40岁,无饮酒史,其他病史不详,需要马上排除可能引发猝死的夹层动脉瘤 等急症,在行胸部CT检查时,发现在李先生的食管中段有一条索状的异物长约2.5厘米,两端横跨食道。医生 再三追问病史才了解到,李先生早晨曾经吃过排骨。

  据消化内科副主任医师刘宇慧介绍,李先生食管中的异物位于食道中离门齿26厘米处,此处是食道的一个狭 窄部位,也是主动脉弓的位置,大血管多,coupons abercrombie,是行内窥镜下异物嵌除术还是开胸取出确实很难选择。因为异物的两端尖锐,如果用胃镜下嵌取,稍有不慎划破 血管,病人瞬间就可能因为大出血而危及生命,此时再上手术台开胸根本来不及。

  虽然风险很大,病人还是同意先行内窥镜嵌除术。手术是10点30分进行的,术中内窥镜到达食道中段时, 需要格外小心,异物横架在食道中间,两端扎在食道肌层,既要防止划破血管引起大出血,还要防止异物尖端穿破 食道引起穿孔。30分钟后,当这个异物被小心取出时,才发现引起李先生胸痛的原凶是一块2.5厘米长,0. 5厘米宽的猪排骨。

  专家提醒市民,每到年节都是食道异物、咽喉部异物的高发时期,边吃饭边看电视或吃饭过急都易引发,家有 老人、小孩、脑血管病人也需要格外小心。如果食物卡在咽喉部,应先使患者侧卧或俯卧于床上,按压腹部,同时 用手指抠出梗阻的异物。如果进食出现胸痛及食道异物感,应减少活动,尽快就近到医院请医生处置 。
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