浓盐酸摄入致消化道损伤的实验研究和临床报道  

Experimental study and clinical report on the damage of digestive tract caused by concentrated hydrochloric acid

作　　者：张汝钢[1] 赵义茗 郭亮亮 蔡逢春[1] 赵亚力[2] 李亚卓[3] 

机构地区：[1]解放军总医院海南分院消化科,海南三亚572013 [2]解放军总医院海南分院中心实验室,海南三亚572013 [3]解放军总医院海南分院病理科,海南三亚572013

出　　处：《胃肠病学和肝病学杂志》2016年第5期538-541,共4页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的探讨腐蚀性液体对消化道损伤的诊断方法。方法利用广范试纸检测腐蚀性液体的p H值,利用硝酸银溶液、氯化钡溶液、铜丝和浓硫酸检测该液体的化学性质;灌注该液体于2只家兔,检测其对消化道损伤的程度;对误服该液体的1例患者进行急诊胃镜检查并救治。结果腐蚀性液体呈微黄色,在空气中发烟,pH<1。该液体稀释1倍后加入硝酸银溶液有白色沉淀,与铜丝和浓硫酸混合后加热无红棕色气体产生。灌注该液体于家兔能够导致其死亡,尸检显示贲门、胃底和部分胃体黏膜层、黏膜下层和肌层出血、坏死。患者误服该液体第17小时胃镜检查主要显示胃大部糜烂,第13天胃镜检查主要显示胃窦和胃角溃疡,第79天胃镜检查显示胃窦瘢痕。经禁食水、抑酸、抗感染等治疗14 d,患者临床表现缓解出院。结论该腐蚀性液体为工业浓盐酸,主要损伤胃黏膜,急诊胃镜检查是可行的。Objective To investigate the diagnostic methods of digestive tract injury caused by caustic liquid. Methods pH value and its chemical properties of caustic liquid were detected by the universal indicator paper and corresponding chemical agents. The degree of the caustic gastroesophageal lesions was evaluated by rabbit experiment, and emergency gastroscopy and corresponding manages were performed to the patient. Results The caustic liquid was yellowish, smoking at atmosphere and its pH value less than 1. The white precipitate was shown at once after the caustic liquid diluted double mixed with silver nitrate solution and marron gas was not produced after it was mixed with copper wire and concertrated sulfuric acid. The rabbits were immediately died after the caustic liquid poured into from mouth, and autopsy showed that bleeding and necrosis of mucosal layer, submucosal layer and muscularis propria in cardia, gastric fundus and part body. Gastroscope results after the ingestion of corrosive liquid showed that erosion of major stomach at the 17th hour, ulcer of gastric antrum and angle at the 13th day, and scar of gastric autrum at the 79th day. The patient discharged from hospital with no discomfort after the corresponding manage for 14 days. Conclusion The caustic liquid is industrial concentrated hydrochloric acid, stomach is mainly been corrosive and the emergency gastroscopy may be safely performed.

关 键 词：浓盐酸 兔 胃镜 

分 类 号：R57[医药卫生—消化系统]