Лечение химических ожогов пищевода у детей

Abstract

Objective . To study the treatment efficacy of chemical burns of the esophagus in children with different grades of lesion. Material and methods . For the last seven years in Dnipropetrovsk Regional Children’s Clinical Hospital there were 192 children on treatment with a diagnosis of chemical burn of the esophagus, out of them 108 (56.25%) boys and 84 (43.75%) girls, and prevailed children aged 1-3 years who made up 102 (53.1%). Among damaging agents caused esophageal burns were more often caustic ones 95 (49.47%). In most cases, there was grade II of lesion of esophageal burns in 71 (36.98%) children. Treatment of post-burn esophagitis includes detoxification, stomach lavage, pain management, antibiotic therapy, short course of corticosteroids. Estimation of the patient’s status provided during the first twenty-four hours. Further the restoration of esophageal patency was conducted with the use of instrumental methods of treatment. The main method of corrosive strictures of esophagus was gullet bougienage and dilation. Results . The patients of the study group were treated using bougie over guidewire dilators. Application of this methodology in treatment of patients with the esophageal burns allowed considerably reduce the amount of cicatrical esophageal stenosis, as well as such complications as perforations and mediastinitis. Conclusion . Proper provision of primary care and the selection of correct diagnostic and treatment tactics of patients with chemical burns of the esophagus helps to reduce complications and disability in children with this pathology.