García Merino F, Martínez Caro A, García Vallés C
Departamento de Cirugía Pediátrica, Hospital Infantil Virgen del Rocío, Sevilla.
An Esp Pediatr. 1988 Oct;29(4):293-7.
A 14-years revision (1972-1986) is made of 3,600 children attended to after ingesting some type of caustic agent. Only 81 were admitted to hospital. We found a predominance in the 1-3 year age group. Bleach was the caustic most frequently present but lye accounted for most major lesions. The more relevant symptoms were oropharyngeal lesions (85%), vomiting (26%) and sialorrhea (20%). Oropharyngeal burns was the sign most often found in esophageal lesions (45%). The ingestion of ordinary household bleach did not result in serious esophageal lesions nor posterior complications, and does not require esophagoscopy if no other symptom except vomiting is present. Esophagoscopy is the ideal means for evaluating esophageal lesions, as are esophageal dilatations with Rehbein dilators for stenosis due to scarring. With the use of corticosteroids in the acute phase, there were 8 cases (22%) of esophageal stenosis out of 36 with lesions.
对3600名摄入某种苛性剂的儿童进行了为期14年(1972 - 1986年)的随访。仅81名儿童入院治疗。我们发现1 - 3岁年龄组占比最大。漂白剂是最常出现的苛性剂,但强碱导致了大多数严重损伤。较相关的症状为口咽损伤(85%)、呕吐(26%)和流涎(20%)。口咽烧伤是食管损伤中最常出现的体征(45%)。摄入普通家用漂白剂未导致严重食管损伤及后期并发症,若除呕吐外无其他症状则无需进行食管镜检查。食管镜检查是评估食管损伤的理想方法,使用雷贝因扩张器进行食管扩张治疗瘢痕性狭窄也是如此。在急性期使用皮质类固醇治疗的36例有损伤的病例中,有8例(22%)出现食管狭窄。