Department of Pediatrics Gastroenterology, Children's Hospital of China Medical University, Taichung, Taiwan; Department of Pediatrics, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan.
Department of Pediatrics Gastroenterology, Children's Hospital of China Medical University, Taichung, Taiwan; School of Medicine, China Medical University, Taichung, Taiwan.
J Formos Med Assoc. 2021 Oct;120(10):1907-1913. doi: 10.1016/j.jfma.2020.12.027. Epub 2021 Jan 7.
Ingestion of alkaline substances should not be disregarded because a small amount can cause chemical burns in the esophagus, with esophageal stricture being the most common late complication.
We enrolled children with alkaline corrosive damage receiving treatment at China Medical University Children's Hospital's emergency department between 2008 and 2018. Patients were divided into groups A (ingested causative agents other than alkaline oil), and B (ingested alkaline oil).
Altogether, 40 (27 [67.5%] male and 13 [32.5%] female) patients aged 7 months-7 years were enrolled. The most commonly ingested agent was alkaline oil (13 cases, 32.5%), followed by oven and drainage cleaners (8 cases, 20%), bleach (6 cases, 15%), laundry and dish cleaners (4 cases, 10%), sodium hydroxide (4 cases, 10%), sodium carbonate (2 cases, 5%), sodium phosphate (2 cases, 5%), and sodium citrate (1 case, 2.5%). High proportions of children had esophagitis (40/40, 100%), erosive gastritis (7/40, 17.5%), and gastric ulcer (6/40, 15%). The incidence of esophageal stricture was 38.4% (5/13) and 7.4% (2/27) in groups B and A, respectively. In group B, 4 children developed growth stunting or malnutrition during the first decade after onset, with reduced immunity and feelings of inferiority.
Alkaline ingestion usually results in esophageal injury that is difficult to cure. Corrosive esophageal strictures cause swallowing difficulties and growth stunting in children. Young children who ingested alkaline oil have more complications. Given that alkaline corrosive injuries are often accidental, prevention of corrosive agent ingestion is crucial.
摄入碱性物质不应被忽视，因为少量即可导致食管化学性灼伤，食管狭窄是最常见的晚期并发症。
我们纳入了 2008 年至 2018 年在中国医科大学附属盛京医院急诊科接受治疗的碱性腐蚀性损伤患儿。患者分为 A 组（摄入碱性油以外的致伤物）和 B 组（摄入碱性油）。
共纳入 40 例（男 27 例[67.5%]，女 13 例[32.5%]）7 个月-7 岁患儿。最常摄入的药物是碱性油（13 例，32.5%），其次是烤箱和排水清洁剂（8 例，20%）、漂白剂（6 例，15%）、洗衣和洗碗清洁剂（4 例，10%）、氢氧化钠（4 例，10%）、碳酸钠（2 例，5%）、磷酸氢二钠（2 例，5%）和柠檬酸钠（1 例，2.5%）。多数患儿存在食管炎（40/40，100%）、腐蚀性胃炎（7/40，17.5%）和胃溃疡（6/40，15%）。B 组患儿食管狭窄的发生率为 38.4%（5/13），A 组为 7.4%（2/27）。B 组有 4 例患儿在发病后 10 年内出现生长迟缓或营养不良，免疫功能下降，伴有自卑心理。
碱性物质摄入通常会导致食管损伤，难以治愈。腐蚀性食管狭窄导致儿童吞咽困难和生长迟缓。摄入碱性油的幼儿并发症更多。鉴于碱性腐蚀性损伤多为意外，预防腐蚀性物质摄入至关重要。
