自杀或探索性致死性摄入后的所有患者都需要EGD吗?
Michael Levine1, Yaron Finkelstein2, William J Trautman3
1Department of Emergency Medicine, University of California, 1100 Glendon Ave. Suite 1200, Los Angeles, CA, 90024, USA. michaellevine@mednet.ucla.edu.
概括
常规EGD不需要无症状的患者自杀性腐蚀性摄入. 酸性摄入的无症状患者可以仅通过观察来管理,类似于基本摄入.
科学领域:
- 胃肠病学 胃肠病学
- 毒理学 毒理学 毒理学
- 紧急医疗 紧急医疗
背景情况:
- 诱导性摄入,虽然不常见,但引起显著的发病率.
- 紧急食管胃管腺镜检查 (EGD) 经常进行,但其在无症状患者的常规必要性是有争议的.
- 这项研究涉及EGD在无症状自杀性摄入中的有用性,以及对无症状酸性摄入的单独观察.
研究的目的:
- 为了评估在自杀性腐蚀性摄入后无症状患者常规EGD的诊断价值.
- 仅通过观察来评估无症状无意中摄入酸性物质的安全性和有效性.
主要方法:
- 对14家医院 (2014-2020年) 的409名患者进行了回顾性分析.
- 收集的数据包括症状,食道损伤,物质pH值,摄入原因和结果.
- 统计分析,包括多变量回归,比较了酸性/基本性和自杀性/非自杀性摄入之间的伤害率.
主要成果:
- 酸性和性摄入之间燃烧速率没有显著差异.
- 像消化不良或失声症这样的症状与严重的食道损伤相关.
- 重要的是,没有无症状的患者出现显著的食道烧伤.
结论:
- 常规EGD不适用于无症状的患者,有食性摄入.
- 无症状患者,无论酸性或性物质,都可以在观察下安全管理.
- 这些发现支持在有毒摄入后对EGD采取更有选择性的方法.
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