Plaisier P W, van Buuren H R, Bruining H A
Department of General Surgery, University Hospital Dijkzigt of the Rotterdam Erasmus University, The Netherlands.
Eur J Surg. 1997 Dec;163(12):903-7.
To investigate the role of upper gastrointestinal (GI) endoscopy in a surgical intensive care unit [ICU].
Retrospective analysis.
University hospital, The Netherlands.
87 Male and 42 female patients, mean age 62.0 years (range 14-86).
198 Upper GI endoscopies.
Incidence of, indication for, and abnormalities noted at upper GI endoscopy.
52 (40%) and 18 (14%) patients underwent 82 and 27 upper GI endoscopies, respectively, for evaluation of upper GI haemorrhage and surgical anastomoses. 59 Patients (46%) underwent 89 endoscopies for placement of nasoduodenal feeding tubes (n = 86, 97%), biliary stents (n = 2, 2%) and gastrostomy cathether (n = 1, 1%). The causes of haemorrhage were: oesophagitis (n = 13, 25%), duodenal ulcer (n = 13, 25%), gastric ulcer (n = 7, 13%) and others (n = 14, 28%). In 6 cases (11%), no bleeding site was detected. As a coincidental finding, a third of all patients had oesophagitis. The incidence of haemorrhage in patients treated and not treated by mechanical ventilation was 43/1350 (3.2%) and 9/1470 (0.6%), respectively (p < 0.0001).
Upper GI endoscopy is a common diagnostic and therapeutic procedure in a surgical ICU. Reflux oesphagitis is often found and is clinically important. Mechanical ventilation is a risk factor for upper GI haemorrhage.
探讨上消化道内镜检查在外科重症监护病房（ICU）中的作用。
回顾性分析。
荷兰大学医院。
87例男性和42例女性患者，平均年龄62.0岁（范围14 - 86岁）。
198例上消化道内镜检查。
上消化道内镜检查的发生率、适应证及发现的异常情况。
分别有52例（40%）和18例（14%）患者接受了82次和27次上消化道内镜检查，以评估上消化道出血和手术吻合口情况。59例患者（46%）接受了89次内镜检查，用于放置鼻十二指肠喂养管（n = 86，97%）、胆管支架（n = 2，2%）和胃造瘘管（n = 1，1%）。出血原因包括：食管炎（n = 13，25%）、十二指肠溃疡（n = 13，25%）、胃溃疡（n = 7，13%）及其他（n = 14，28%）。6例（11%）未发现出血部位。作为偶然发现，所有患者中有三分之一患有食管炎。接受机械通气和未接受机械通气患者的出血发生率分别为43/1350（3.2%）和9/1470（0.6%）（p < 0.0001）。
上消化道内镜检查是外科ICU中常见的诊断和治疗手段。反流性食管炎常被发现且具有临床重要性。机械通气是上消化道出血的一个危险因素。
