食管异物内镜诊疗的研究进展

Advances in Endoscopic Diagnosis and Treatment of Esophageal Foreign Bodies

摘要: 食管异物是消化内科与急诊科常见的上消化道急症，延误处置可引发食管穿孔、纵隔炎、主动脉食管瘘等严重并发症，甚至危及生命。近年来，随着内镜诊疗技术发展、影像学技术进步及多学科协作模式推广，食管异物的诊疗已从传统被动取物，转向涵盖术前风险评估、术中术式选择、术后并发症管理的综合路径。本文梳理近十年国内外高质量临床研究与权威指南，从流行病学与本土化疾病谱、术前多维风险评估、内镜治疗策略等多个维度展开综述，总结当前领域的共识与争议，分析研究局限并展望未来方向，尝试构建适配我国疾病谱特征的阶梯式内镜诊疗路径，以期为临床决策提供参考。

Abstract: Esophageal foreign body (EFB) is a common upper gastrointestinal emergency in gastroenterology and emergency medicine. Delayed intervention can result in severe complications, including esophageal perforation, mediastinitis, and aortoesophageal fistula, posing a life-threatening risk. In recent years, with advances in endoscopic techniques, imaging modalities, and multidisciplinary team (MDT) collaboration, the management of esophageal foreign bodies has transitioned from conventional passive extraction to an integrated pathway encompassing preoperative risk stratification, intraoperative procedural optimization, and postoperative complication management. This review synthesizes high-quality clinical studies and authoritative guidelines from the past decade, examining dimensions such as epidemiology and localized disease spectrum, preoperative multidimensional risk assessment, and endoscopic therapeutic strategies. It summarizes current consensus and ongoing controversies, analyzes research limitations, and proposes future directions. Moreover, it attempts to construct a stepped endoscopic management pathway adapted to the disease spectrum characteristics in China, in hopes of providing a reference for clinical decision-making.