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| 題 名 | 口腔至空腸嚴重化學腐蝕性灼傷 |
|---|---|
| 作 者 | 吳明和; | 書刊名 | 中華民國外科醫學會雜誌 |
| 卷 期 | 20:6 1987.11[民76.11] |
| 頁 次 | 頁524-528 |
| 分類號 | 416.141 |
| 關鍵詞 | 口腔; 空腸; 化學腐蝕性灼傷; |
| 語 文 | 中文(Chinese) |
| 中文摘要 | 近十二年,經歷120例吞食腐蝕性化學物質之傷患。其中十一例緊急手術。發現腐蝕性灼傷限於幽門以上之消化道有七例,另四例灼傷延至空腸。彼渚中兩例死亡。兩例存活。吞食高濃度腐蝕性化學物質,由口腔。經食道、胃、十二指腸至空腸。除引起上述器官嚴重傷害外,特蔓延至周團之縱隔腔、橫隔膜、肋膜腔、脾、膽囊及腹膜腔等。嚴重腐蝕性灼傷,不但造成各部位之壞死,穿孔,同時引起尿毒,代謝性酸中毒,休克及呼吸衰竭,其死亡率極高。成功的救活口腔至空腸嚴重腐蝕性灼傷傷患,誠屬不易。除治療休克、酸鹼平衡,維持呼吸機能外,並需要切除食道、胃、十二指腸、部份空腸及鄰近器官,而後完成頸部食道造瘻,膽道空腸吻合術,胰臟空腸吻合術及空腸造瘻術。其病情,手術方法及手術前後之照顧,將詳細敘述。 |
| 英文摘要 | Caustic ingestion usually causes damage confined to the oropharynx, esophagus & stomach. ln some instances, damage may extend to duodenum, jejunum and surrounding organs and tissues, such as mediastinum, pleural cavity, spleen, gall bladder and diaphragm with a consequently high mortality rate. In addition to management of shock, respiratory support and maintenance of acid-base balance, radical resection of the damaged organs with reconnection of bile and pancreatic ducts to the digestive passages is also important. In a series of 4 consecutive cases, successful treatment was achieved for 2 patients. In the first case, after extraction of thoracic esophagus and resection of stomach, duodenum and 40 cm of jejunum for corrosive necrosis & gastric perforation, cervical esophagostomy, choledocho-jejunostomy, pancreaticojejunostomy and feeding jejunostomy were performed with good result after 4 months of follow up. In the second case, following extraction of thoracic esophagus and resection of stomach, duodenum, 5 cm of jejunum and gall bladder for corrosive necrosis and gastric perforation, cervical esophagostomy, choledocho-jejunostomy and pancreaticojejunostomy were performed with good results up to 5 years & 6 months of follow up. |
本系統中英文摘要資訊取自各篇刊載內容。