在儿科胃肠内镜检查中识别阳性穿孔
Oren Ledder1,2, Marek Woynarowski3, Diana Kamińska4
1From Juliet Keidan Institute of Paediatric Gastroenterology, Shaare Zedek Medical Center, Jerusalem, Israel.
Journal of pediatric gastroenterology and nutrition
|June 5, 2023
概括
儿童胃肠内镜 (GIE) 穿孔是罕见但严重的. 大多数穿孔在12小时内被发现,经常出现疼痛和发烧,指导更好的术后监测.
科学领域:
- 儿科胃肠病学 儿科胃肠病学
- 胃肠内镜检查 胃肠内镜检查
- 手术并发症 手术并发症
背景情况:
- 催化剂粘膜穿孔是儿科胃肠内镜 (GIE) 的罕见但严重并发症.
- 目前缺乏基于证据的指导方针,用于在术后立即跟踪检测穿孔.
- 这项研究旨在描述GIE后穿孔儿童的表现,以告知管理建议.
研究的目的:
- 在胃肠内镜检查后的儿童中,描述iatrogenic粘膜穿孔的临床表现.
- 确定儿科内镜后穿孔的诊断和管理策略的时间.
- 为制定基于证据的程序后后续推提供数据.
主要方法:
- 来自欧洲,北美和中东中心的聚合数据的回顾性分析.
- 数据来自ESPGHAN和NASPGHAN的附属内镜专利小组收集的数据.
- 用于程序和患者数据收集的标准化REDCap病例报告表格.
主要成果:
- 鉴定出59例粘膜穿孔病例,平均年龄为6岁.
- 穿孔最常发生在食管胃管腺镜检查 (49%) 和胆管结肠镜检查 (44%) 后.
- 超过一半 (48%) 的穿孔在手术过程中被发现,80%在12小时内被发现,经常出现疼痛和发烧.
结论:
- 在儿科胃肠内镜检查后发生的阳性穿孔很少见,但及时识别至关重要.
- 大多数穿孔在12小时内被发现,疼痛和发烧等临床症状是关键指标.
- 这些数据可以为儿童患者的手术后随访和监测制定指导原则.
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