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惊险!88岁老人鱼刺卡喉拖延3天后,刺穿食管直逼颈总动脉
隆昌融媒 2025-07-17 15:40:40

近日,隆昌市人民医院耳鼻咽喉头颈外科为一名88岁高龄老人实施医院首例颈侧切开食管内异物取出术。

据悉,患者陈阿婆在进食时不慎误食一根鱼刺,她赶紧喝醋、吞米饭、吞青菜...以为把鱼刺“吞”下去就没事了,可是3天过去了,喉咙疼痛愈加严重,基本不能进食进饮,随即到耳鼻咽喉头颈外科就诊,经CT检查,清晰可见一根长约3cm的鱼刺,已经完全穿透食管,在食管外面。从CT上显示鱼刺位置特殊,位于甲状腺上面、临近胸廓入口紧邻颈总动脉仅仅只有0.3cm,随时都可能刺破颈总动脉发生大出血危及生命,后果不堪设想,必须尽快取出。

管床医师立即将这一特殊情况向耳鼻咽喉头颈外科主任范贤勇汇报,科室迅速启动院内MDT讨论程序,立即会同消化内科、手术麻醉科进行多学科讨论,一致认为,患者存在高龄风险,尽可能采取微创的方式取出鱼刺,但在胃镜下仔细探查未发现异物,于是立即启动第二套手术方案,通过颈侧切开取出鱼刺。经颈侧切开后,穿过颈部复杂的解剖结构,撑开甲状腺上叶,在不损伤正常肌肉、血管和神经的情况下,分离颈部血管、肌肉及神经,保护好颈总动脉后,成功将鱼刺取出,手术用时仅45分钟。

医生回忆道,在门诊接诊了不少鱼刺卡喉的患者,多数能够通过胃镜、食道镜及喉镜顺利取出异物,像这例通过颈侧切开取出的还是第一次遇到。

温馨提醒,吃带刺、有骨头的食物时切记要小心,感觉到被异物卡喉后,用醋、团饭、菜叶等吞咽均不可取,只会是将异物越压越紧、越卡越深,还可能刺破食管或血管,形成脓肿,危害更大。正确的处理是立即停止进食,及时就医,卡在口、咽及下咽部的鱼刺可用喉镜取出,食道的异物可以通过胃镜及硬质食管镜取出。

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