Eggstein S, Langkau S, Rückauer K, Salm R, Farthmann E H
Abteilung Allgemeine Chirurgie mit Poliklinik, Chirurgische Universitätsklinik Freiburg.
Zentralbl Chir. 1995;120(2):103-9.
We report a retrospective analysis of 61 patients admitted during the years 1974 to 1992 after having recently swallowed a corrosive agent. Within 24 hours, the localisation, severity and extent of the injury had been determined by endoscopy. In 13 patients the injury was restricted to the oropharynx, and in 48 it involved esophagus, stomach and duodenum. Fourteen had sustained a second degree injury, and 16 a third degree injury. Out of five patients with third degree injuries who were treated by operation within the first three days, two survived. Two patients operated upon for complications after 10 days of conservative treatment died. The total mortality was 21%, but 56% for those who had received a third degree injury. Thirteen patients developed a stenosis (27% of those with gastroesophageal lesions). Esophageal strictures were dilatated with bougies, but stomach stenoses were treated by resection. Of the 12 patients treated by dilatation, 4 sustained perforations and 4 of them were free of symptoms for a considerable period of time (more than 4 years).
我们报告了对1974年至1992年间因近期吞食腐蚀性物质而入院的61例患者的回顾性分析。在24小时内，通过内镜检查确定了损伤的部位、严重程度和范围。13例患者的损伤仅限于口咽，48例涉及食管、胃和十二指肠。14例为二度损伤，16例为三度损伤。在前三天接受手术治疗的5例三度损伤患者中，2例存活。10天保守治疗后因并发症接受手术的2例患者死亡。总死亡率为21%，但三度损伤患者的死亡率为56%。13例患者出现狭窄（占胃食管病变患者的27%）。食管狭窄用探条扩张，但胃狭窄采用切除术治疗。在接受扩张治疗的12例患者中，4例发生穿孔，其中4例在相当长一段时间内（超过4年）无症状。
