洗胃术致胃食管损伤四例并文献复习

Gastric Lavage Induced Gastric Esophageal Injury: A Report of Four Cases and Literature Review

目的探讨洗胃术致胃食管损伤的临床特点并分析发生原因。方法结合相关文献对4例洗胃术致胃食管损伤的临床资料进行回顾性分析。结果本组均因急性中毒行洗胃术,术中发生急性胃穿孔3例,食管损伤1例。行胃穿孔修补术后痊愈1例;死亡3例,于术中猝死1例,术后1 h死于消化道出血1例,继发腹膜炎行剖腹探查胃穿孔修补术后死于脓毒症1例。结论患者配合插胃管、防止恶心呕吐、轻柔操作和改善洗胃机设计是减少洗胃严重并发症的关键。

Objective To investigate the clinical characteristics of gastric lavage induced gastric esophageal injury and analyze its causes. Methods Based on a literature review, the clinical data of four patients with gastric lavage induced gastric esophageal injury was retrospectively analyzed. Results Four patients with gastric lavage in this group were due to the acute poisoning. Among them, three patients suffered acute gastric perforation and one suffered esophageal injury in the period of gastric lavage performing. One patient was fully recovery after the repair operation, and the other three patients died. A-mong the three died patients, one died suddenly during the operation, one died of gastrointestinal hemorrhage 1 h after the op-eration, and the other patient died of sepsis after the repair of gastric perforation in exploratory laparotomy for secondary perito-nitis. Conclusion Patients＆#39; coordination, preventing nausea and vomiting and gentle operation in gastric tube insertion and improving gastric lavage machine design may be the keys to reduce the complications of gastric lavage.