Andreoni B, Marini A, Gavinelli M, Biffi R, Tiberio G, Farina M L, Rossi A
Department of Emergency Surgery, University School of Medicine, Ospedale Maggiore Policlinico, Milan, Italy.
Surg Today. 1995;25(2):119-24. doi: 10.1007/BF00311082.
A study of 57 patients admitted to the Department of Emergency Surgery at the Ospedale Maggiore in Milan between 1980 and 1992 following the recent ingestion of a caustic substance is presented herein. Through this study, an aggressive diagnostic and therapeutic approach has been employed, including early surgery which plays a fundamental role in the prevention of acute hemorrhagic or perforative complications as well as in the development of scar tissue and neoplastic strictures over time. The criteria for early emergency surgery were the presence of endoscopic grade 3 and 4 lesions as well as those on the borderline between grades 2 and 3 with clinical symptoms. In 11 patients with lesions of moderate severity, the treatment of choice was medical therapy, which required subsequent surgical intervention for strictures in 5 patients. In 13 patients with severe lesions, an early surgical approach was performed with a mortality rate of 23%.
本文介绍了一项对1980年至1992年间因近期摄入腐蚀性物质而入住米兰马焦雷医院急诊外科的57例患者的研究。通过这项研究，采用了积极的诊断和治疗方法，包括早期手术，早期手术在预防急性出血或穿孔并发症以及随着时间推移瘢痕组织和肿瘤性狭窄的形成方面起着重要作用。早期急诊手术的标准是存在内镜下3级和4级病变以及2级和3级之间边界且伴有临床症状的病变。在11例中度严重病变患者中，首选治疗方法是药物治疗，其中5例患者随后因狭窄需要手术干预。在13例严重病变患者中，采用了早期手术方法，死亡率为23%。
