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首页> 外文期刊>Surgical Endoscopy >Clinical evaluation and management of caustic injury in the upper gastrointestinal tract in 95 adult patients in an urban medical center.
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Clinical evaluation and management of caustic injury in the upper gastrointestinal tract in 95 adult patients in an urban medical center.

机译：市区医疗中心95名成年患者上消化道苛性损伤的临床评估和处理。

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BACKGROUND: Caustic ingestion causes a wide spectrum of injuries; appropriate treatment varies according to the severity and extent of the injury. This retrospective study of adult patients with caustic injury presents the endoscopic findings, treatment regimen, and clinical outcome. METHODS: Over a 28-year period, 95 consecutive adult patients admitted to an urban emergency hospital for ingestion of caustic materials were studied. Each patient underwent early endoscopy and the injury was graded for severity. There were 61 men and 34 women with an average age of 37.2 years (range 17 to 81). Ingestion was due to a suicide attempt in 49 patients and accidental in 46 patients. RESULTS: Ten patients showed no mucosal damage. The remaining 85 patients had grade I superficial injury in 47 patients, grade II moderate injury in 25 patients, and deep grade III injury in 13 patients. The ingestion of strong acid or strong alkali often produced deep grade III changes while bleach, detergent, ammonia or other substances usually caused grade I injury. Operative interventions were required for 11 patients with grade III injury and 6 patients with grade II injury. Endoscopic grading was predictive for the onset of complications including late esophageal stricture. There were no complications due to endoscopy; one patient with grade III and multiple comorbidities died from multiple organ failure. CONCLUSION: Upper gastrointestinal endoscopy after caustic ingestion should be performed early to define the extent of injury and guide appropriate therapy. Grade I injuries heal spontaneously. Grade II injuries may be treated conservatively but repeat endoscopy helps define when intervention is needed. Grade III injuries ultimately require surgical intervention.
机译：背景：食入会引起广泛的伤害。适当的治疗方法取决于受伤的严重程度和程度。这项针对成年患者的苛刻性损伤的回顾性研究显示了内窥镜检查结果，治疗方案和临床结局。方法：在28年的时间里，对95名连续住院的成人患者进行了研究，他们均因摄入腐蚀性物质而被送进城市急诊医院。每位患者均接受早期内镜检查，并对损伤进行了严重程度分级。男61例，女34例，平均年龄37.2岁（范围17至81）。摄入是由于49位患者自杀未遂而意外的46位患者。结果：10例患者无粘膜损伤。其余的85例患者中I级浅表损伤为47例，II级中度损伤为25例，深III级损伤为13例。摄入强酸或强碱通常会产生深Ⅲ级变化，而漂白剂，洗涤剂，氨水或其他物质通常会造成Ⅰ级伤害。 11名III级损伤患者和6名II级损伤患者需要手术干预。内窥镜分级可预示并发症的发生，包括食管晚期狭窄。内镜检查无并发症。一名III级和多种合并症患者死于多器官功能衰竭。结论：食盐摄入后应尽早进行上消化道内镜检查，以确定损伤程度并指导适当的治疗。一级伤自发愈合。 II级损伤可以保守治疗，但重复内镜检查有助于确定何时需要干预。 III级损伤最终需要手术干预。

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