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腐蚀性物质的摄入以及内镜检查在评估腐蚀性损伤严重程度中的作用。

Ingestion of corrosive substances and the endoscopic role in assessing the severity of caustic injury.

作者信息

Simonovska Natasha, Stefanovska Vesna Velikj, Babulovska Aleksandra, Pereska Zanina, Jurukov Irena, Berat-Huseini Afrodita, Kostadinovski Kristin, Naumovski Kiril

机构信息

Clinical Centre, University Clinic for Toxicology, Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, Republic of North Macedonia.

Institute of Epidemiology and Biostatistics, Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, Republic of North Macedonia.

出版信息

Prz Gastroenterol. 2023;18(2):183-189. doi: 10.5114/pg.2023.129415. Epub 2023 Jul 27.

Abstract

INTRODUCTION

The ingestion of caustic substances into the upper gastrointestinal tract is an unusual but potentially life-threatening problem.

AIM

To evaluate the most commonly ingested corrosive substances, and the endoscopic findings, complications, and final outcomes of caustic intake.

MATERIAL AND METHODS

This cross-sectional study included 220 inpatient participants with corrosive poisonings during a 3-year period (2017-2019). Data from the national patient electronic system "My term" and from the "Poisoning information centre" at the University Clinic for Toxicology, Skopje were used. Demographic characteristics, type of corrosive substance, endoscopic findings by Kikendall classification, emerging complications, fatal outcome, and hospitalization were analysed. Data obtained were analysed with the SPSS software package, version 22.0 for Windows.

RESULTS

During the period 2017-2019, out of 220 hospitalized cases with corrosive substance intake, 132 (60%) were with ingestion of acids, 19 (8.6%) with bases, 32 (14.6%) with bleaches, and 37 (16.8%) with other household products ( = 0.3469). The mean age of patients was 49.89 ±19.86 years. The most severe endoscopy findings (high-grade injury) were significantly more often associated with acid and base ingestion ( = 0.00001). Out of all strictures, 25 (64.1%) were on one location (either oesophagus or stomach), and 12 (30.8%) were on 2 locations.

CONCLUSIONS

Upper gastrointestinal endoscopy is very important procedure for rapid assessment of severity of caustic injury, early appropriate therapy, as well as the potential development of strictures. The obtained data are very important for the development of a national program for the prevention of corrosive poisoning in our country.

摘要

引言

腐蚀性物质摄入上消化道是一个不常见但可能危及生命的问题。

目的

评估最常摄入的腐蚀性物质,以及腐蚀性物质摄入后的内镜检查结果、并发症和最终结局。

材料与方法

这项横断面研究纳入了2017年至2019年这3年期间220例腐蚀性中毒住院患者。使用了来自国家患者电子系统“My term”以及斯科普里大学毒理学诊所“中毒信息中心”的数据。分析了人口统计学特征、腐蚀性物质类型、Kikendall分类的内镜检查结果、出现的并发症、死亡结局和住院情况。使用适用于Windows的SPSS 22.0软件包对获得的数据进行分析。

结果

在2017年至2019年期间,220例腐蚀性物质摄入住院病例中,132例(60%)摄入了酸,19例(8.6%)摄入了碱,32例(14.6%)摄入了漂白剂,37例(16.8%)摄入了其他家用产品(P = 0.3469)。患者的平均年龄为49.89±19.86岁。最严重的内镜检查结果(重度损伤)与酸和碱摄入显著更相关(P = 0.00001)。在所有狭窄病例中,25例(64.1%)位于一个部位(食管或胃),12例(30.8%)位于两个部位。

结论

上消化道内镜检查对于快速评估腐蚀性损伤的严重程度、早期适当治疗以及狭窄的潜在发展非常重要。所获得的数据对于我国制定预防腐蚀性中毒的国家计划非常重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a667/10395062/5a9907399f56/PG-18-51069-g001.jpg

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