Jakobsen K B, Schurizek B A
Arhus Kommunehospital, anaestesiologisk afdeling.
Ugeskr Laeger. 1993 Sep 20;155(38):2998-3002.
Pulmonary aspiration of stomach contents is a common clinical problem. Symptoms and consequences depend on the aspired volume, the pH and the content of food particles and bacteria. There are two phases following an aspiration of stomach contents into the lungs. The first phase is nonspecific and begins a few minutes after the aspiration. This phase is due to the chemical injury. The second phase is an inflammatory reaction. The reaction is haemorrhagic, granulocytic and necrotizing when the aspirate is acid (pH < 2.5). The presence of food particles causes granulomas. The immunological reactions are biphasic as well. The bacterial infection is mainly secondary to the chemical inflammation and occurs with an infection rate of 25-50%. The optimum management is symptomatic and should entail immediate endotracheal suction, aggressive ventilatory support with supplemental oxygen, CPAP or PEEP if indicated by clinical assessment and blood gas measurements, adequate fluid replacement and antibiotics if there is evidence of bacterial infection.
胃内容物的肺吸入是一个常见的临床问题。症状和后果取决于吸入量、pH值以及食物颗粒和细菌的含量。胃内容物吸入肺部后有两个阶段。第一阶段是非特异性的，在吸入后几分钟开始。此阶段是由于化学损伤所致。第二阶段是炎症反应。当吸入物呈酸性（pH<2.5）时，该反应为出血性、粒细胞性和坏死性。食物颗粒的存在会导致肉芽肿。免疫反应也是双相的。细菌感染主要继发于化学性炎症，感染率为25% - 50%。最佳处理方法是对症治疗，应立即进行气管内吸引，根据临床评估和血气测量结果，如有需要，给予积极的通气支持，补充氧气、持续气道正压通气（CPAP）或呼气末正压通气（PEEP），充分补液，如有细菌感染的证据则使用抗生素。
