Karnak I, Tanyel F C, Büyükpamukçu N, Hiçsönmez A
Department of Pediatric Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey.
J Cardiovasc Surg (Torino). 1999 Apr;40(2):307-10.
If an esophageal burn is diagnosed, the aim is to prevent stricture formation. The combined use of steroid, antibiotics and early bougienage (SAEB) is one of the currently used treatment protocols. The effect of SAEB treatment against stricture formation following caustic esophageal burn has been evaluated retrospectively.
Forty-nine children of 282 admitted with a history of caustic substance ingestion were found to have esophageal burns. Forty-nine children underwent treatment against stricture formation. SAEB was begun within 48 hours of ingestion.
Eight children of 12 who ingested sodium hydroxide and five children of 20 who ingested acids developed strictures in spite of the therapy. Additionally two esophageal perforations were encountered in patients who ingested sodium hydroxide.
This protocol has been found to carry a risk of perforation without preventing stricture formation after strong alkali ingestion. Therefore other treatment modalities for preventing strictures should be evaluated especially in children who have ingested products containing strong alkalis.
如果诊断出食管烧伤，目标是预防狭窄形成。类固醇、抗生素和早期探条扩张术联合使用（SAEB）是目前使用的治疗方案之一。已对SAEB治疗腐蚀性食管烧伤后预防狭窄形成的效果进行了回顾性评估。
在282例有腐蚀性物质摄入史的住院儿童中，49例被发现有食管烧伤。49例儿童接受了预防狭窄形成的治疗。SAEB在摄入后48小时内开始。
尽管进行了治疗，但12例摄入氢氧化钠的儿童中有8例以及20例摄入酸的儿童中有5例出现了狭窄。此外，摄入氢氧化钠的患者中出现了2例食管穿孔。
已发现该方案在摄入强碱后有穿孔风险，且不能预防狭窄形成。因此，应评估其他预防狭窄的治疗方式，尤其是在摄入含强碱产品的儿童中。
