摘要
应用纤维内镜对31例烧伤病人进行了上消化道ASML研究,内镜追踪13例,粘膜活检16例。资料显示烧伤面积大于30%时,ASML发生率为100%,其严重程度与烧伤面积、伤后镜检时间、有无合并症有关;87%有胆汁返流,随着伤情和合并症的控制,ASML和胆汁返流也渐恢复。上消化道出血均发生在有严重ASML的患者。16例粘膜病理表现较轻,与内镜所见不全一致,内镜技术为研究烧伤后ASML的重要方法。
31 burned patients were studied by fiber-endoscopy. We found that the incidence rate of acute stress mucosal lesion (ASML) of upper gastrointestinal tract was 100% in which burns involved more than 30% of total body surface. The degree of severity of ASML ap- peared to be influenced by the areas of the burn and the duration between examination and occurence of burn. It was also related to the existence of complications. The study of endoscopic findings revealed that ASML had a special development course. It consisted of congestion, edema. erosion, bleeding and ulceration, The acute ulceration was only a part of the whole course. The incidence rate of the stressulcer of this group was 27.6%. The bleeding rate was 34.5%. The bile reflux was 87% in 29 patients. Endoscopic examination can not only recognize the nature of the ASML, but also can collect the incidence rate accurately and find the location of the bleeding and ulcer in time. So this provided an important method for the etilogical study. If the examination is well prepared and handled carefully, the procedure is very safe.
