Song Hye Kyung, Shim Ki Nam, Yun Hye Won, Tae Chung Hyun, Kim Seong Eun, Jung Hye Kyung, Jung Sung Ae, Yoo Kwon
Department of Health Promotion Medicine, Ewha Womans University Medical Center Mokdong Hospital, Seoul, Korea.
Department of Internal Medicine, Ewha Medical Research Institute, Ewha Womans University School of Medicine, Seoul, Korea.
Korean J Gastroenterol. 2015 Jan;65(1):12-20. doi: 10.4166/kjg.2015.65.1.12.
BACKGROUND/AIMS: Caustic ingestion can cause severe injury to upper gastrointestinal tract. There were few studies about clinical characteristics and treatments of caustic injury in Korea. We investigated the changes in clinical features of caustic injury over the past 20 years including pattern of endoscopic mucosal injury and treatment modality.
This study was a retrospective review of medical records from patients with caustic injury from September 1993 through December 2012. Patients were classified into two groups based on the year when caustic ingestion occurred: patients who visited the hospital from 1993 to 2002 (early group) and patients who visited the hospital from 2003 to 2012 (late group).
A total 140 patients were included (early group [n=50] vs. late group [n=90]). Annual number of caustic ingestions did not show decreasing tendency over the past 20 years. Alkali ingestion increased (20.0% vs. 65.6%, p<0.001) and cases with more than grade 2b of esophageal mucosal injury decreased (41.3% vs. 20.7%, p=0.012) in late group. There were no differences between two groups in sex, age, proportion of accidental ingestion, and systemic/gastrointestinal complications. Use of gastric lavage (p<0.01) and broad spectrum antibiotics (p=0.03) decreased in late group. However, there was no difference in use of steroid between two groups.
In this study, overall caustic ingestion did not decrease and ingestion of alkali agents increased over the past 20 years. Tighter legislation on caustic agents is required and we need to be alert to the best management of caustic injury.
背景/目的：腐蚀性物质摄入可导致上消化道严重损伤。韩国关于腐蚀性损伤的临床特征及治疗的研究较少。我们调查了过去20年中腐蚀性损伤临床特征的变化，包括内镜下黏膜损伤模式及治疗方式。
本研究对1993年9月至2012年12月期间腐蚀性损伤患者的病历进行回顾性分析。根据腐蚀性物质摄入发生年份将患者分为两组：1993年至2002年就诊的患者（早期组）和2003年至2012年就诊的患者（晚期组）。
共纳入140例患者（早期组[n = 50] vs. 晚期组[n = 90]）。过去20年中腐蚀性物质的年摄入量未呈下降趋势。晚期组中碱摄入增加（20.0% vs. 65.6%，p < 0.001），食管黏膜损伤超过2b级的病例减少（41.3% vs. 20.7%，p = 0.012）。两组在性别、年龄、意外摄入比例及全身/胃肠道并发症方面无差异。晚期组洗胃（p < 0.01）和广谱抗生素的使用（p = 0.03）减少。然而，两组在类固醇使用方面无差异。
在本研究中，过去20年中腐蚀性物质的总体摄入量未减少，碱性物质的摄入量增加。需要对腐蚀性物质实施更严格的立法，我们需要警惕对腐蚀性损伤的最佳管理。
