Christesen H B
Otologisk afdeling, Arhus Kommunehospital.
Ugeskr Laeger. 1993 Aug 2;155(31):2379-82.
The incidence of caustic ingestion varies with the availability of caustic products and preventive measures. A transient increase was seen in the US round 1970, in Denmark in the late seventies. Diagnosis and treatment of caustic ingestion injuries remains controversial, and must to a high degree be based on retrospective studies and animal studies, especially concerning the pathology and clinical course of the disease. These subjects are reviewed together with complications and prognosis. It is stressed, that ingestion of alkalies and acids result in a variety of lesions, depending on a number of factors listed. Ingestion of alkalies occurs in approximately 85% of all cases, with oesophageal stricture as the most frequent complication, and tracheal necrosis as the most frequent cause of death. Ingestion of acid in large amounts may lead to early gastric perforation, massive metabolic acidosis, and eventual death. Pyloric stenosis is the most common complication of acid ingestion. Approximately 33% of all patients admitted with (suspected) caustic injury reveal oesophageal damage. This leads to subsequent oesophageal stricture in 10-15%. Mortality is less than 10% in unselected groups.
腐蚀性物质摄入的发生率因腐蚀性产品的可得性和预防措施而异。在美国，1970年左右出现了短暂上升，在丹麦，七十年代后期也出现了类似情况。腐蚀性物质摄入损伤的诊断和治疗仍存在争议，在很大程度上必须基于回顾性研究和动物研究，尤其是关于该疾病的病理学和临床过程。本文将对这些主题以及并发症和预后进行综述。需要强调的是，碱和酸的摄入会导致多种病变，这取决于所列的一些因素。约85%的病例为碱摄入，食管狭窄是最常见的并发症，气管坏死是最常见的死亡原因。大量酸摄入可能导致早期胃穿孔、严重代谢性酸中毒并最终死亡。幽门狭窄是酸摄入最常见的并发症。所有因（疑似）腐蚀性损伤入院的患者中，约33%存在食管损伤。这会导致10%至15%的患者随后出现食管狭窄。在未经过筛选的群体中，死亡率低于10%。
