Lipper B, Simon D, Cerrone F
Department of Medicine, Albert Einstein College of Medicine, Bronx Municipal Hospital Center, NY.
Crit Care Med. 1991 Mar;19(3):330-3. doi: 10.1097/00003246-199103000-00008.
To evaluate the frequency and significance of aspiration and its clinical importance in patients with upper GI bleeding undergoing esophagogastroduodenoscopy in the ICU.
Thirty consecutive patients with active and severe upper GI bleeding were studied.
ICU.
Ranged in age from 20 to 78 yr with an equal number of males and females.
All patients had continuous pulse oximetry monitoring and had chest radiographs obtained less than 12 hr before endoscopy and less than 4 hr after endoscopy.
Six (20%) of 30 patients developed new lung infiltrates after esophagogastroduodenoscopy. In this group of patients, preendoscopy chest radiographs were obtained after less than 4 hr. In five of these patients, infiltrates were accompanied by fever and/or leukocytosis and oxygen desaturation to less than 90% during the esophagogastroduodenoscopy.
Clinically significant aspiration pneumonia frequently complicates esophagogastroduodenoscopy in upper GI bleeding patients and is an important mechanism of esophagogastroduodenoscopy-induced hypoxia.
评估重症监护病房（ICU）中接受食管胃十二指肠镜检查的上消化道出血患者误吸的发生率、意义及其临床重要性。
对连续30例有活动性严重上消化道出血的患者进行研究。
ICU。
年龄范围为20至78岁，男女数量相等。
所有患者均进行连续脉搏血氧饱和度监测，并在内镜检查前不到12小时及内镜检查后不到4小时拍摄胸部X光片。
30例患者中有6例（20%）在食管胃十二指肠镜检查后出现新的肺部浸润。在这组患者中，内镜检查前胸部X光片是在不到4小时内拍摄的。其中5例患者的浸润伴有发热和/或白细胞增多，并且在食管胃十二指肠镜检查期间氧饱和度降至90%以下。
具有临床意义的误吸性肺炎常使上消化道出血患者的食管胃十二指肠镜检查复杂化，并且是食管胃十二指肠镜检查引起缺氧的重要机制。
