Isakov I F, Stepanov E A, Razumovskiĭ A I, Timoshchenko O V
Khirurgiia (Mosk). 1996(4):4-8.
On the basis of experience in the treatment of 2339 patients with chemical burns of the esophagus the authors hold that, despite its traumatic character, early prophylactic bougienage is the method of choice in the prevention of cicatricial esophageal strictures. The method has become more effective today because the aggressive properties of cauterizing agents have been significantly reduced in the recent decades. The use of modern fiberoptics has greatly widened the diagnostic possibilities of endoscopy. The above circumstances have made it possible to develop and introduce into clinical practice a new differential approach to the diagnosis and treatment of chemical burns of the esophagus in children. This complex method allows, with much probability, to differentiate Degrees II and III burns in the early periods and thus free a large group of patients with Degree II esophageal burn from needless bougienage. The method leads practically to 100% prevention of stenoses and complete restoration of the organ function, reduces markedly the period of hospitalization of the patients, and allows outpatients treatment in 42% cases.
根据对2339例食管化学烧伤患者的治疗经验,作者认为,尽管早期预防性探条扩张术具有创伤性,但它仍是预防瘢痕性食管狭窄的首选方法。由于近几十年来腐蚀剂的腐蚀性已显著降低,该方法如今变得更加有效。现代纤维光学技术的应用极大地拓宽了内镜检查的诊断可能性。上述情况使得开发一种针对儿童食管化学烧伤的诊断和治疗的新的鉴别方法并将其引入临床实践成为可能。这种综合方法很有可能在早期区分Ⅱ度和Ⅲ度烧伤,从而使一大批Ⅱ度食管烧伤患者免于不必要的探条扩张术。该方法几乎能100%预防狭窄并使器官功能完全恢复,显著缩短患者的住院时间,42%的病例可进行门诊治疗。