Janousek Petr, Kabelka Zdenek, Rygl Michal, Lesný Petr, Grabec Pavel, Fajstavr Jaroslav, Jurovcík Michal, Snajdauf Jirí
ENT Clinic of the 2nd Medical Faculty, Paediatric ENT Department, Charles University, Motol, Prague 2MF CU, Czech Republic.
Int J Pediatr Otorhinolaryngol. 2006 Jun;70(6):1103-7. doi: 10.1016/j.ijporl.2005.03.057. Epub 2006 Mar 30.
This study examined a cohort of pediatric patients treated for suspected corrosive injury of the oesophagus in the ENT department between 1994 and 2003.
During the study period we examined 337 patients. All patients were treated according to an individual diagnostico-therapeutic protocol that included: foremost, early rigid oesophagoscopy; intensive medical therapy; nasogastric tube placement; and/or surgical intervention.
Our proposed system of grading on a scale from 0 to 4 was used to classify the findings upon oesophagoscopy. One hundred eighty eight patients (55.7%) had a negative exam; 1st degree corrosive injury was present in 58 patients (17.4%); 2nd and 3rd degree injury in 81 patients (24%); and 4th degree was found in 10 patients (3%).
Because the endoscopic findings were positive in 44% of patients with suspected corrosive injury, early rigid oesophagoscopy is indicated in all patients suspected of having corrosive injury even in the absence of clinical symptoms.
本研究对1994年至2003年间在耳鼻喉科接受疑似食管腐蚀性损伤治疗的一组儿科患者进行了检查。
在研究期间,我们检查了337例患者。所有患者均按照个体化诊断治疗方案进行治疗,该方案包括:首先是早期硬质食管镜检查;强化药物治疗;鼻胃管置入;和/或手术干预。
我们提出的0至4级分级系统用于对食管镜检查结果进行分类。188例患者(55.7%)检查结果为阴性;58例患者(17.4%)存在1级腐蚀性损伤;81例患者(24%)存在2级和3级损伤;10例患者(3%)发现为4级损伤。
由于44%疑似腐蚀性损伤患者的内镜检查结果为阳性,因此即使没有临床症状,所有疑似腐蚀性损伤的患者均应进行早期硬质食管镜检查。