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腐蚀性物质摄入:何时进行内镜检查?

Corrosive Substance Ingestion: When to Perform Endoscopy?

作者信息

Ateş Ufuk, Göllü Gülnur, Ergün Ergun, Serttürk Fırat, Jafarov Anar, Bülbül Merve, Evin Ege, Sözduyar Sümeyye, Koloğlu Meltem Bingöl, Çakmak Ahmet Murat

机构信息

Faculty of Medicine, Department of Pediatric Surgery, Ankara University, Ankara, Turkey.

Department of Pediatric Surgery, Ankara Etlik City Hospital, Ankara, Turkey.

出版信息

J Paediatr Child Health. 2025 Jun;61(6):967-973. doi: 10.1111/jpc.70064. Epub 2025 Apr 21.

Abstract

AIM

Ingestion of corrosive substances is a difficult and important medical problem to manage. The aim of this study is to present an algorithm that will regulate the treatment and follow-up of paediatric patients with corrosive ingestion.

METHODS

Children who were admitted to the paediatric emergency department with corrosive substance ingestions between July 2015 and December 2021 were included. Between July 2015 and January 2020, endoscopy was performed on all patients. After January 2020, endoscopy was performed only for patients presenting with hypersalivation and dysphagia.

RESULTS

172 patients were followed up and treated in our clinic due to corrosive substance ingestion. Endoscopic evaluation of 19 patients with hypersalivation revealed oesophageal corrosion stages as follows: grade I in 5 patients, grade II-A in 1 patient, grade II-B in 3 patients, and normal findings in the remaining patients. Of the 14 patients with dysphagia, 1 had grade I, 2 had grade II-A, and 4 had grade II-B corrosion, and the remaining patients had normal endoscopic findings. In the long-term follow-up of the patients without hypersalivation and dysphagia, no complications developed and no additional treatment was required.

CONCLUSIONS

In patients presenting with suspicion of ingestion of high risk corrosive substances, there is no need for endoscopy unless hypersalivation and dysphagia are present simultaneously.

摘要

目的

腐蚀性物质摄入是一个难以处理且重要的医学问题。本研究的目的是提出一种算法,用于规范腐蚀性物质摄入的儿科患者的治疗和随访。

方法

纳入2015年7月至2021年12月因腐蚀性物质摄入而入住儿科急诊科的儿童。2015年7月至2020年1月期间,对所有患者进行了内镜检查。2020年1月之后,仅对出现流涎过多和吞咽困难的患者进行内镜检查。

结果

172例因腐蚀性物质摄入在我院接受随访和治疗。对19例流涎过多的患者进行内镜评估,发现食管腐蚀程度如下:5例为I级,1例为II - A级,3例为II - B级,其余患者检查结果正常。14例吞咽困难的患者中,1例为I级,2例为II - A级,4例为II - B级腐蚀,其余患者内镜检查结果正常。在对流涎过多和吞咽困难均未出现的患者进行长期随访时,未发生并发症,也无需额外治疗。

结论

对于疑似摄入高风险腐蚀性物质的患者,除非同时出现流涎过多和吞咽困难,否则无需进行内镜检查。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/387e/12128724/ca972bd5dc99/JPC-61-967-g001.jpg

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