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胃急性腐蚀性损伤:一个单位三十年的经验

Acute corrosive injuries of the stomach: a single unit experience of thirty years.

作者信息

Ananthakrishnan N, Parthasarathy G, Kate Vikram

机构信息

Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry 605006, India.

出版信息

ISRN Gastroenterol. 2011;2011:914013. doi: 10.5402/2011/914013. Epub 2010 Oct 28.

Abstract

Introduction. The spectrum of gastric injury due to corrosives can vary. This paper presents a single center experience of over 30 years of corrosive gastric injuries of 39 patients with acute gastric injuries from 1977 till 2006. Patients and Methods. Two thirds of the patients in the acute injury group had a concomitant esophageal injury. The age of the patients ranged from 4 years to 65 years with a slight preponderance of males. (M : F ratio 22 : 17). Results. 36 out of 39 acute gastric injuries were due to ingestion of acids. Three patients had history of caustic soda ingestion. Oral hyperemia or ulcers of varying extent were seen in all patients. The stomach showed hyperemia in 10, extensive ulcers in 13, and mucosal necrosis in 10 patients. Fifteen patients (15/39, 38.5%) were managed conservatively. Twenty four patients (24/39, 61.5%) underwent laparotomy: one for frank peritonitis, 10 for gastric mucosal necrosis, and 13 others for extensive gastric ulcerations. Overall the mortality rate was 29.6 %. Conclusion. Although the mortality and morbidity of acute corrosive gastric injuries is high, the key to improve the survival is early identification of perforation, maintenance of nutrition and control of sepsis.

摘要

引言。腐蚀性物质导致的胃损伤范围可能各不相同。本文介绍了一个单一中心30多年来对1977年至2006年期间39例急性胃损伤患者的腐蚀性胃损伤的经验。患者与方法。急性损伤组中三分之二的患者伴有食管损伤。患者年龄从4岁到65岁不等,男性略占多数(男:女比例为22:17)。结果。39例急性胃损伤中有36例是由于摄入酸性物质所致。3例患者有摄入苛性钠的病史。所有患者均可见不同程度的口腔充血或溃疡。胃黏膜充血的有10例,广泛溃疡的有13例,黏膜坏死的有10例。15例患者(15/39,38.5%)采用保守治疗。24例患者(24/39,61.5%)接受了剖腹手术:1例因明显腹膜炎,10例因胃黏膜坏死,另外13例因广泛胃溃疡。总体死亡率为29.6%。结论。尽管急性腐蚀性胃损伤的死亡率和发病率很高,但提高生存率的关键在于早期识别穿孔、维持营养和控制感染。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cfa7/3168572/61ba20727b45/GASTROENTEROLOGY2011-914013.001.jpg

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