小儿腐蚀性食管炎病因与X线表现的对比研究

Comparative study on the etiology and the radiographic findings of corrosive esophagitis in children

目的 分析小儿腐蚀性食管炎X线表现特点 ,探讨其食管损伤程度与腐蚀剂关系。方法 16例小儿腐蚀性食管炎 ,其中男 14例 ,女 2例 ,年龄 1～ 11岁 ,平均 3 4岁。依据其吞服药物性质 ,剂量与X线表现 ,对其发病部位 ,损伤程度逐一进行对比研究。结果 16例食管狭窄范围平均为10 7cm ,占食管平均总长度的 6 3 4 %,狭窄部位直径 0 1～ 1 2cm。病变累及中段或中下段者 13例 ,占 81 3%。碱性腐蚀剂与酸性腐蚀剂所致食管平均狭窄长度占食管平均总长度的百分比分别为70 5 %和 42 0 %,两者间有显著性差异 (t=2 35 9,P <0 0 5 )。结论 小儿腐蚀性食管炎的狭窄程度与腐蚀剂的性质、浓度及吞服剂量呈正相关 ,发病部位以中段及中下段多见 ,强碱腐蚀剂所致食管损伤范围较酸性腐蚀剂更广泛。

Objective To investigate the relationship between the corrosive and the degree of injured esophagus by analyzing the X-ray findings of corrosive esophagitis(CE) in children. Methods Sixteen cases of CE were reported. There were 14 males and 2 females and the age ranged from 1 to 11 years withe the average of 3.4 years. The aera and degree of the injured esophagus were analyzed respectively according to the characteristic and dose of the corrosive and the X-ray findings. Results The average length of esophageal stricture in 16 cases was 10.7 cm,which was 63.4 percent of the whole esophagus. The width of stricture was 0.1～1.2 cm. The injury occurred in the middle and terminal esophagus in 13 cases (83.1%). The average percentages of the esophageal stricture caused by lyes and acids were 70.5% and 42.0%,respectively. The difference of the two groups was statistically significant (t=2.359, P<0.05). Conclusion Serious and extensive stricture of the CE in children often occurs in the middle and terminal esophagus.The severity of lesions depends on the type, quantity, and concentration of the caustic substance ingested,as well as on the time of contact with the mucosa. The esophageal length of injury caused by lyes is more extensive than that caused by acids.