Bautista Casasnovas A, Estevez Martinez E, Varela Cives R, Villanueva Jeremias A, Tojo Sierra R, Cadranel S
Servicio de Cirugía Pediátrica, Complejo Hospitalario Universitario de Santiago, Santiago of Compostela, Spain.
Eur J Pediatr. 1997 May;156(5):410-4. doi: 10.1007/s004310050627.
We reviewed the case histories of 743 children seen at our hospital from 1981 to 1990 for suspected ingestion of caustic substances. Mean patient age was 27 months; 85% of patients were less than 3 years old. The male-to-female ratio was about 2:1. About 53% of patients were from urban environments. All ingestions appear to have been accidental. Of the 743 children, 20% presented oesophageal burns (11.8% first-degree, 3.1% second-degree and 2.7% third-degree). Alkaline products were ingested about 11 times more frequently than acid products. The substance ingested was bleach in 73% of cases. The most dangerous substances were dishwasher liquids/powders (59% of ingestions led to oesophageal burn), caustic soda (55%) and drain cleaners (55%). The caustic product was not in its original container in 75% of cases. Most accidents (58%) took place in the home. We did not detect any reliable predictive relationship between the presence of symptoms and signs and of oesophageal burns. Of the 743 patients, 5% developed oesophageal stricture and 3% required oesophageal dilatation.
The incidence of accidents caused by the ingestion of caustic substances can only be reduced by broad-based preventive strategies, including enforcement of safe manufacturing practices and public education programmes. Most importantly, the containers for caustic household products should be cheap, small and childproof.
我们回顾了1981年至1990年期间在我院就诊的743例疑似摄入腐蚀性物质儿童的病历。患者平均年龄为27个月；85%的患者年龄小于3岁。男女比例约为2:1。约53%的患者来自城市环境。所有摄入似乎均为意外。在这743名儿童中，20%出现食管烧伤（11.8%为一度，3.1%为二度，2.7%为三度）。碱性产品的摄入频率比酸性产品高约11倍。73%的病例中摄入的物质为漂白剂。最危险的物质是洗碗机液体/粉末（59%的摄入导致食管烧伤）、苛性钠（55%）和下水道清洁剂（55%）。75%的病例中腐蚀性产品不在其原容器中。大多数事故（58%）发生在家中。我们未发现症状和体征与食管烧伤之间存在任何可靠的预测关系。在这743名患者中，5%发生食管狭窄，3%需要进行食管扩张。
只有通过广泛的预防策略，包括实施安全制造规范和开展公众教育项目，才能降低因摄入腐蚀性物质导致的事故发生率。最重要的是，家用腐蚀性产品的容器应该价格便宜、体积小且具有防儿童开启功能。
