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儿童腐蚀性胃食管病变:473例病例分析

Caustic gastroesophageal lesions in childhood: an analysis of 473 cases.

作者信息

Doğan Yaşar, Erkan Tülay, Cokuğraş Fügen Cullu, Kutlu Tufan

机构信息

Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Cerrahpaşa Medical Faculty, Istanbul University, Istanbul, Turkey.

出版信息

Clin Pediatr (Phila). 2006 Jun;45(5):435-8. doi: 10.1177/0009922806289618.

Abstract

Ingested corrosive agents produce oropharyngeal and gastroesophageal injuries ranging from minor burns to severe necrosis, depending on the agent amount, concentration, and duration of exposure. The aim of this study was to present our patients with corrosive ingestion retrospectively. Four hundred seventy-three children younger than 16 years of age (mean age, 3.7+/-0.1 years) who were admitted to our hospital for suspected corrosive ingestion between the years 1995 and 2003 were studied. Two hundred eighty-six (60.5%) of 473 patients were males. Household bleaches (36.6%) and oven cleaners (23%) were the most frequently encountered corrosive agents. During endoscopy, lesions in the esophagus were recorded in 379 children. Eighty-one of the cases had gastric lesions. During the follow-up, esophageal stricture, esophageal perforation, and gastric outlet obstruction (GOO) developed in 11 cases, 1 case, and 2 cases, respectively. Caustic ingestion of alkali substances such as oven cleaner seem to cause more severe injuries. Early admission to the hospital with clinical and endoscopic evaluation and early surgery when required may reduce morbidity and mortality.

摘要

摄入腐蚀性物质会导致口咽和胃食管损伤,损伤程度从轻微烧伤到严重坏死不等,这取决于摄入物质的量、浓度和接触时间。本研究的目的是回顾性地介绍我们收治的腐蚀性物质摄入患者的情况。对1995年至2003年间因疑似腐蚀性物质摄入而入住我院的473名16岁以下儿童(平均年龄3.7±0.1岁)进行了研究。473名患者中有286名(60.5%)为男性。家用漂白剂(36.6%)和炉灶清洁剂(23%)是最常遇到的腐蚀性物质。在内镜检查中,379名儿童记录有食管病变。其中81例有胃部病变。在随访期间,分别有11例、1例和2例出现食管狭窄、食管穿孔和胃出口梗阻(GOO)。摄入苛性碱物质(如炉灶清洁剂)似乎会导致更严重的损伤。早期入院进行临床和内镜评估,并在必要时尽早手术,可能会降低发病率和死亡率。

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