EFFECTIVE TREATMENT OF ACUTE ALKALI INJURY OF THE RAT ESOPHAGUS WITH EARLY SALINE DILUTION THERAPY

被引：13

作者：

HOMAN, CS

MAITRA, SR

LANE, BP

GELLER, ER

机构：

[1] Trauma Research Laboratory, State University of New York at Stony Brook

[2] Department of Emergency Medicine, State University of New York at Stony Brook

[3] Department of Surgery, State University of New York at Stony Brook

[4] Department of Pathology, State University of New York at Stony Brook

来源：

ANNALS OF EMERGENCY MEDICINE | 1993年 / 22卷 / 02期

关键词：

ALKALIS; SODIUM CHLORIDE;

D O I：

10.1016/S0196-0644(05)80198-2

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Background: Controversy persists regarding the appropriate treatment of acute alkali injury to the esophagus. The current study establishes a controlled model of alkali esophageal injury and examines the efficacy of saline dilution therapy. Study hypothesis: Early saline dilution therapy effectively reduces esophageal injury resulting from acute alkali exposure. Methods: The esophagi were harvested from 60 Sprague-Dawley rats. Each end was cannulated with a 20-gauge catheter. Specimens were maintained in an oxygen-perfused saline bath (37 C) during a 60-minute experimental period and then fixed immediately in 10% formalin solution for histologic examination. Three experimental groups (A, B, and C) were perfused with 50% NaOH solution at time zero. Treatment with saline perfusion was performed immediately in group A, five minutes after injury in group B, and 30 minutes after injury in group C. The positive control group D was perfused with saline at time zero. A negative control, group E, was perfused with 50% NaOH at time zero. This group did not receive subsequent treatment with saline. Pathologic examination was performed in a blinded fashion using a score of 0 to 3 (0, no injury; 1, minimal; 2, moderate; 3, severe) for seven histologic criteria: epithelial viability, extent of injury, cornified epithelial cell differentiation, granular cell differentiation, epithelial cell nuclei, muscle cells, and muscle cell nuclei. Results: The positive control group demonstrated scores of zero. Nonparametric analysis showed a significant difference among treatment groups for each injury category. Trend analysis revealed a significant progression of injury for each category associated with time to treatment. Discriminant analysis indicated that the muscle cells category was the most useful category with which to distinguish injury among groups. Conclusion: In our model, saline lavage decreased objective evidence of esophageal injury after a severe alkaline exposure, and early therapy enhanced this beneficial effect.

引用

页码：178 / 182

页数：5

共 23 条

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