Stress ulcer bleeding

被引：16

作者：

Harty R.F. ^{[1
]}

Ancha H.B. ^{[1
]}

机构：

[1] Section of Gastroenterology, Department of Medicine, Oklahoma University Medical Center, Oklahama City, OK 73104

来源：

Current Treatment Options in Gastroenterology | 2006年 / 9卷 / 2期

关键词：

Omeprazole; Intensive Care Unit Patient; Lansoprazole; Misoprostol; Esomeprazole;

D O I：

10.1007/s11938-006-0034-3

中图分类号：

学科分类号：

摘要：

Although upper gastrointestinal (GI) bleeding from stress-related mucosal disease (SRMD) in critically ill patients is common, significant bleeding with hemodynamic instability is not. Risk factor assessment can assist in identifying patients with a greater likelihood of developing significant SRMD. Prophylaxis against stress ulcer bleeding with luminal agents (eg, antacids and sucralfate) or drugs that inhibit acid secretion (eg, histamine 2-receptor antagonists [H2RAs] and proton-pump inhibitors [PPIs]) can reduce major bleeding but has little or no effect on mortality. Currently, the mainstays of prophylactic therapy for SRMD are intravenously administered H2RAs and PPIs. Wider usage of PPIs reflects their enhanced efficacy in suppressing acid secretion as well as lack of tolerance for H2RAs. Guidelines for the prophylactic use of H2RAs or PPIs in treatment of SRMD will require large, randomized studies that also examine cost effectiveness of individual strategies. Copyright © 2006 by Current Science Inc.

引用

页码：157 / 166

页数：9

共 40 条

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