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贝宁城儿童腐蚀性食管损伤的表现和治疗结果。

Presentation and management outcome of childhood corrosive oesophageal injury in Benin City.

机构信息

Department of Surgery, University of Benin Teaching Hospital, Benin City, Nigeria.

Department of Basic Science, Benson Idahosa University, Benin City, Nigeria.

出版信息

Afr J Paediatr Surg. 2020 Jul-Dec;17(3 & 4):74-78. doi: 10.4103/ajps.AJPS_90_10.

Abstract

BACKGROUND

Corrosive ingestion in children occurs usually at home and frequently results in debilitating strictures. Prevention and early intervention programs are very important for good outcomes.

AIMS AND OBJECTIVES

This study aims at examining the immediate causative factors and problems of this subset of patients with a special focus on treatment and outcome. This study was to audit the management of patients in the paediatric age group who presented for treatment with history and sequelae of corrosive ingestion seen by the cardiothoracic unit of the University of Benin Teaching Hospital from January 2005 till December 2018.

MATERIALS AND METHODS

This is a 14year retrospective study of patients that presented with oesophageal burn injuries from ingestion of corrosive agents to the Cardiothoracic Unit at the University of Benin Teaching Hospital between January 2005 and December 2018. Essentially the first 5years were retrospectively included but the subsequent years were prospective. All available medical data on these patients were retrieved and studied for epidemiological, clinical and operative procedures and outcome.

RESULTS

A total of 49 patients were seen and admitted during the period under review. Male (29) : Female (20) ratio was 1:1.4 Mean age was 4.7±4.8 years with a range of 1-16years, The males presented earlier and had worse strictures as well as more surgical procedures. Caustic soda preparations ingested more (93.9%), all ingestions were within the household setting, and all had first aid given by way of oral palm oil. Only two (4.1%) ingested acids with only one flat battery ingestion. 45.5% of the patients had dilatation only and of these 50% recovered after 3 sessions and required no more sessions. A further 50% were lost to follow up. 38.8% had oesophageal replacement with colon following oesophagectomy.

CONCLUSION

In conclusion, corrosive oesophageal stricture is a debilitating disease in children and affects males more, but it is treatable by multiple dilatations and oesophageal replacement with colon. Prevention should be actively pursued as well as early intervention.

摘要

背景

儿童腐蚀性摄入通常发生在家庭中,经常导致衰弱性狭窄。预防和早期干预计划对于取得良好效果非常重要。

目的和目标

本研究旨在检查这组患者的直接致病因素和问题,特别关注治疗和结果。本研究旨在审查 2005 年 1 月至 2018 年 12 月期间,贝宁大学教学医院心胸外科收治的因腐蚀性摄入而出现病史和后遗症的儿科患者的治疗管理情况。

材料和方法

这是一项对 2005 年 1 月至 2018 年 12 月期间在贝宁大学教学医院心胸外科就诊的食管烧伤患者进行的 14 年回顾性研究。最初的 5 年是回顾性纳入的,但随后的几年是前瞻性的。对这些患者的所有可用医疗数据进行了检索和研究,以了解其流行病学、临床和手术过程以及结果。

结果

在审查期间,共收治 49 例患者。男性(29 例)与女性(20 例)的比例为 1:1.4。平均年龄为 4.7±4.8 岁,范围为 1-16 岁。男性患者更早就诊,且狭窄更严重,手术次数也更多。摄入的是苛性苏打制剂(93.9%),所有摄入物均在家庭环境中发生,并且都通过口服棕榈油进行了急救。只有 2 例(4.1%)摄入了酸,只有 1 例摄入了扁平电池。45.5%的患者仅接受了扩张治疗,其中 50%在 3 次治疗后恢复,无需再进行治疗。另有 50%的患者失去随访。38.8%的患者进行了食管切除和结肠替代。

结论

总之,腐蚀性食管狭窄是儿童的一种衰弱性疾病,男性患者更多,但可通过多次扩张和结肠替代进行治疗。应积极预防,并尽早干预。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b203/8051635/f502bee7c3b4/AJPS-17-74-g001.jpg

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