Gaudreault P, Parent M, McGuigan M A, Chicoine L, Lovejoy F H
Pediatrics. 1983 May;71(5):767-70.
The accuracy of signs and symptoms as predictors of the presence and severity of esophageal injury was evaluated in 378 children admitted to three pediatric hospitals between 1970 and 1980. The signs and symptoms analyzed included nausea, vomiting, dysphagia, refusal to drink, abdominal pain, increased salivation, oropharyngeal burns, and abdominal tenderness. The severity of lesions found at esophagoscopy in 378 children was graded from grade 0, no lesion, to grade 3, perforation. Of the 298 patients demonstrating signs or symptoms, 243 (82%) had a grade 0 or 1 lesion, 55 (18%) had a grade 2 lesion, none had a grade 3 lesion, and five (2%) developed a stricture of the esophagus. Among the 80 patients without signs or symptoms, 70 (88%) had a grade 0 or 1 lesion, ten (12%) had a grade 2 lesion, none had a grade 3 lesion, and one (1%) developed a stricture of the esophagus. When individual signs or symptoms were correlated with the severity of esophageal lesion, vomiting (33%) followed by dysphagia (25%), excessive salivation (24%), and abdominal pain (24%) were most frequently associated with a grade 2 or 3 esophageal lesion. A similar percentage of a grade 0 or 1 (82% v 85%), a grade 2 (18% v 15%), and a grade 3 (0%) esophageal lesion followed the ingestion, respectively, of an alkali (324 patients) or an acid (54 patients). In six patients (2%) stricture occurred only following an alkali ingestion. These data demonstrate that signs and/or symptoms do not adequately predict the presence or severity of an esophageal lesion following the ingestion of a caustic substance.
1970年至1980年间，对三家儿科医院收治的378名儿童进行了评估，以确定体征和症状作为食管损伤存在及严重程度预测指标的准确性。分析的体征和症状包括恶心、呕吐、吞咽困难、拒饮、腹痛、流涎增多、口咽烧伤和腹部压痛。在378名儿童中，通过食管镜检查发现的病变严重程度从0级（无病变）到3级（穿孔）进行分级。在298名有体征或症状的患者中，243名（82%）有0级或1级病变，55名（18%）有2级病变，无3级病变，5名（2%）出现食管狭窄。在80名无体征或症状的患者中，70名（88%）有0级或1级病变，10名（12%）有2级病变，无3级病变，1名（1%）出现食管狭窄。当将个体体征或症状与食管病变的严重程度相关联时，呕吐（33%），其次是吞咽困难（25%）、流涎过多（24%）和腹痛（24%）与2级或3级食管病变最为相关。分别摄入碱（324例患者）或酸（54例患者）后，0级或1级（82%对85%）、2级（18%对15%）和3级（0%）食管病变的比例相似。6例患者（2%）仅在摄入碱后出现狭窄。这些数据表明，体征和/或症状不能充分预测摄入腐蚀性物质后食管病变的存在或严重程度。
