Fisher R A, Eckhauser M L, Radivoyevitch M
Surg Gynecol Obstet. 1985 Jul;161(1):91-9.
Following acid ingestion, the mortality of operative intervention is clearly related to late recognition of perforation. Experimentally, fiber-optic endoscopy can be used to accurately predict the depth of gastric injury. Operative intervention can be undertaken before gross perforation. Flexible endoscopy should be performed upon admission and repeated at intervals of 12 to 24 hours until one is satisfied that the injury is stable, reversible and will not progress. The risk of gastric perforation is minimal if the endoscopic procedure is performed by a competent individual. Continued careful medical follow-up examination and nutritional support is indicated when major damage to the stomach occurs to ensure that the patient will tolerate anticipated operative reconstruction.
摄入酸性物质后，手术干预的死亡率显然与穿孔的延迟识别有关。在实验中，纤维光学内镜可用于准确预测胃损伤的深度。可在出现明显穿孔之前进行手术干预。入院时应进行软性内镜检查，并每隔12至24小时重复检查一次，直到确认损伤稳定、可逆且不会进展。如果由胜任的人员进行内镜操作，胃穿孔的风险极小。当胃部发生严重损伤时，需要持续进行仔细的医学随访检查并给予营养支持，以确保患者能够耐受预期的手术重建。
