Arnold Marion, Numanoglu Alp
Division of Paediatric Surgery, University of Cape Town, Red Cross War Memorial Children's Hospital, Cape Town, South Africa.
Division of Paediatric Surgery, University of Cape Town, Red Cross War Memorial Children's Hospital, Cape Town, South Africa.
Semin Pediatr Surg. 2017 Apr;26(2):95-104. doi: 10.1053/j.sempedsurg.2017.02.002. Epub 2017 Feb 3.
Various domestic or industrial chemicals may cause significant upper aerodigestive tract burns. Preventive measures should be up-scaled, especially in the developing world, to reduce the epidemic of accidental victims, largely unsupervised preschool children. External signs do not predict degree of injury. Non-invasive diagnostic screening includes radio-nuclear imaging, but early oesophago-gastroduodenoscopy remains the standard to predict stricture formation from circumferential submucosal scarring. Serial dilation is the mainstay of oesophageal stricture therapy, with oesophageal replacement reserved for severe refractory strictures. Intra-lesional steroid or mitomycin C may decrease the dilatations required for severe strictures, although long-term effects are unknown. Risk of secondary oesophageal carcinoma mandates long-term surveillance.
各种家用或工业化学品可能导致严重的上消化道烧伤。应加强预防措施，尤其是在发展中世界，以减少意外受害者的数量，这些受害者大多是无人监管的学龄前儿童。外部体征无法预测损伤程度。非侵入性诊断筛查包括放射性核素成像，但早期食管胃十二指肠镜检查仍然是预测环形黏膜下瘢痕形成导致狭窄的标准方法。系列扩张是食管狭窄治疗的主要方法，食管置换仅用于严重难治性狭窄。病灶内注射类固醇或丝裂霉素C可能会减少严重狭窄所需的扩张次数，尽管其长期效果尚不清楚。继发性食管癌的风险要求进行长期监测。
