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上消化道腐蚀性损伤:仍然是一个主要的外科难题。

Corrosive injury to upper gastrointestinal tract: Still a major surgical dilemma.

作者信息

Keh Siew Min, Onyekwelu Nzewi, McManus Kieran, McGuigan Jim

机构信息

The Royal National Nose, Throat and Ear Hospital, London, WC1X 8DA, United Kingdom.

出版信息

World J Gastroenterol. 2006 Aug 28;12(32):5223-8. doi: 10.3748/wjg.v12.i32.5223.

Abstract

In the developed and developing countries, corrosive injury to the gastrointestinal system as a consequence of either accidental ingestion or as a result of self-harm has become a less common phenomenon compared to decades ago. This could partly be attributed to the tighter legislation imposed by the government in these countries on detergents and other corrosive products and general public awareness. Most busy upper gastrointestinal surgical units in these countries, especially in the developed countries will only encounter a small number of cases per year. Up to date knowledge on the best management approach is lacking. In this article, we present our experience of two contrasting cases of corrosive injury to the upper gastrointestinal tract in our thoracic unit in the last 2 years and an up-to-date Medline literature search has been carried out to highlight the areas of controversies in the management of corrosive injuries of the upper gastrointestinal tract. We concluded that the main principle in managing such patients requires a good understanding of the pathophysiology of corrosive injury in order to plan both acute and future management. Each patient must be evaluated individually as the clinical picture varies widely. Signs and symptoms alone are an unreliable guide to injury.

摘要

在发达国家和发展中国家,与几十年前相比,因意外摄入或自残导致的胃肠道腐蚀性损伤已成为一种不太常见的现象。这部分可归因于这些国家政府对洗涤剂和其他腐蚀性产品实施的更严格立法以及公众意识的提高。在这些国家,尤其是发达国家,大多数繁忙的上消化道外科科室每年只会遇到少数病例。目前缺乏关于最佳管理方法的最新知识。在本文中,我们介绍了过去两年我们胸科对上消化道腐蚀性损伤的两个对比病例的经验,并进行了最新的医学文献检索,以突出上消化道腐蚀性损伤管理中的争议领域。我们得出结论,管理此类患者的主要原则是需要很好地理解腐蚀性损伤的病理生理学,以便规划急性和未来的管理。由于临床表现差异很大,每个患者都必须单独评估。仅凭体征和症状作为损伤的指导并不可靠。

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