南非夸祖鲁纳塔尔省青少年和成人摄入高锰酸钾后损伤严重程度的回顾性研究

Samantha J. Beningfield, Emily A. Webber, G. Oosthuizen, S. Čačala
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摘要

简介:高锰酸钾(KMnO4)是青少年和成人腐蚀性摄入的罕见原因;在最近的文献中只发现了病例报告。在南非的恩格韦莱扎纳医院,摄入KMnO4并不是一个罕见的入院指征。KMnO4很容易获得,在大多数家庭中使用,并被传统保健医生推荐用于医疗目的。目的:确定摄入KMnO4的原因,上消化道研究确定的损伤程度和严重程度,以及与全球现有文献比较的患者结局。方法:我们对26例服用KMnO4后入住成人病房的青少年和成人患者进行了回顾性研究。收集患者人口统计数据,摄入KMnO4的原因和摄入量。口腔检查和上消化道研究结果用Zargar分级记录食管和胃的腐蚀性损伤。记录患者的结果和住院时间。结果:女性占73%,男性占27%,平均年龄23岁。误食原因包括副自杀(84%)、意外误食(8%)和缓解腹痛(8%)。绝大多数(96%)以溶液形式而不是以固体形式吞食KMnO4。所取KMnO4的体积和浓度难以量化。58%的患者出现口腔变色、水肿和溃疡。胃肠内窥镜检查占92%;68%出现异常(食管损伤14%,食管和胃损伤14%,单独胃损伤41%)。食管损伤:n = 6;Zargar等级1-83%,Zargar等级2A-17%。胃损伤:n = 12;Zargar等级1-42%,Zargar等级2A-33%, Zargar等级2B-25%。平均住院时间2.9天(范围2-8天)。6周无死亡,无并发症。结论:青少年和成人误食KMnO4的情况并不少见,大多与自杀未遂有关,且多以液体形式误食。KMnO4可能是低浓度的,因为没有注意到全身并发症,与其他地方摄入KMnO4后粘膜坏死的病例报告相比,胃和食管损伤较轻。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A Retrospective Study of the Severity of Injury following Potassium Permanganate Ingestion in Teenagers and Adults in KwaZulu Natal, South Africa
Introduction: Potassium Permanganate (KMnO4) is an uncommon cause of caustic ingestion in teenagers and adults; only case reports are found in the recent literature. At Ngwelezana Hospital in South Africa, KMnO4 ingestion is not an uncommon indication for admission. KMnO4 is readily available as used in most households and recommended for medicinal purposes by traditional health practitioners. Aim: To ascertain the reasons for KMnO4 ingestion, the extent and severity of injury as determined by upper gastro-intestinal studies, and patient outcomes in comparison with the available global literature. Methods: We performed a retrospective study of 26 teenage and adult patients, admitted to our adult wards following KMnO4 ingestion. Data collected on patient demographics, reason for KMnO4 ingestion, and quantity ingested. Oral inspection and upper gastro-intestinal study findings recorded with grading (Zargar) of corrosive injury to oesophagus and stomach. Patients’ outcome and duration of hospital stay documented. Results: There were 73% females and 27% males, with an average age of 23 years. Reasons for ingestion included parasuicide (84%), accidental ingestion (8%), and for relief of abdominal pain (8%). The vast majority (96%) swallowed KMnO4 in solution rather than in solid form. The volume and concentration of KMnO4 taken was difficult to quantify. Oral discoloration, oedema, and ulceration were found in 58%. Gastro-intestinal endoscopy was performed in 92%; abnormalities were demonstrated in 68% (oesophageal injury 14%, oesophageal and gastric injuries 14%, gastric injury alone 41%). Oesophageal injuries: n = 6; Zargar grade 1—83%, Zargar grade 2A—17%. Gastric injuries: n = 12; Zargar grade 1—42%, Zargar grade 2A—33%, Zargar grade 2B—25%. Average hospital stay was 2.9 days (range 2–8 days). There were no mortalities and no complications at 6 weeks. Conclusion: KMnO4 ingestion by teenagers and adults is not uncommon in our setting, mostly related to suicide attempts and most often taken in liquid form. KMnO4 was possibly of a low concentration as no systemic complications were noted and there were milder gastric and oesophageal injuries as compared to case reports from elsewhere of mucosal necrosis following ingestion of KMnO4.
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