Cello J P
University of California, San Francisco.
Scand J Gastroenterol Suppl. 1990;175:146-58. doi: 10.3109/00365529009093138.
Over the next several decades the gastroenterologist practicing anywhere in the world will be confronted with patients with AIDS-related gastrointestinal disorders. Universal body substance isolation precautions should be practiced, however, in dealing with all patients, including those outside traditional 'risk' groups for AIDS. Principal among these precautions are using gloves for personnel involved in procedures and high-level disinfection or sterilization for all endoscopy equipment. Endoscopic procedures should be planned well in advance with special attention to endoscope selection and transport media availability. Organ-associated symptoms are reviewed, especially dysphagia, odynophagia, hemorrhage, diarrhea, and abdominal pain. Opportunistic infections and malignancies often present characteristic endoscopic appearances such as that seen for cytomegalovirus ulceration or Kaposi's sarcoma. AIDS-related biliary disorders should also be recognized, principally sclerosing cholangitic or papillary stenosis.
在接下来的几十年里，世界各地的胃肠病学家都会遇到患有艾滋病相关胃肠道疾病的患者。然而，在治疗所有患者时，包括那些不属于传统艾滋病“风险”群体的患者，都应采取普遍的体液隔离预防措施。这些预防措施中主要包括，参与操作的人员要戴手套，所有内镜设备要进行高水平消毒或灭菌。内镜检查程序应提前做好规划，尤其要注意内镜的选择和运输介质的可用性。要对器官相关症状进行评估，特别是吞咽困难、吞咽痛、出血、腹泻和腹痛。机会性感染和恶性肿瘤通常呈现出特征性的内镜表现，如巨细胞病毒溃疡或卡波西肉瘤所见。还应认识到艾滋病相关的胆道疾病，主要是硬化性胆管炎或乳头狭窄。
