Institute of Digestive Disease, Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.
Therap Adv Gastroenterol. 2010 Jan;3(1):11-22. doi: 10.1177/1756283X09352095.
Intravenous (IV) proton-pump inhibitors (PPIs) are potent gastric acid suppressing agents, and their use is popular in clinical practice. Both IV and oral PPIs have similarly short half-lives, and their effects on acid secretion are similar, thus their dosing and dosage intervals appear to be interchangeable. The possible exception is when sustained high pHs are required to promote clot stabilization in bleeding peptic ulcers. Continuous infusion appears to be the only form of administration that reliably achieves these high target pHs. IV PPI is indicated in the treatment of high-risk peptic ulcers, complicated gastroesophageal reflux, stress-induced ulcer prophylaxis, Zollinger-Ellison syndrome, and whenever it is impossible or impractical to give oral therapy. The widespread use of PPIs has been controversial. IV PPIs have been linked to the development of nosocomial pneumonia in the intensive care setting and to spontaneous bacterial peritonitis in cirrhotic patients. This review discusses the use of IV PPI in different clinical scenarios, its controversies, and issues of appropriate use.
静脉内（IV）质子泵抑制剂（PPIs）是强效胃酸抑制药，在临床实践中广泛应用。IV 和口服 PPI 的半衰期相似，对胃酸分泌的作用也相似，因此它们的剂量和给药间隔似乎可以互换。可能的例外是需要持续高 pH 值以促进出血性消化性溃疡中的血栓稳定时。连续输注似乎是唯一可靠地达到这些高目标 pH 值的给药方式。IV PPI 用于治疗高危消化性溃疡、复杂胃食管反流、应激性溃疡预防、卓-艾综合征，以及当无法或不实际进行口服治疗时。PPIs 的广泛应用一直存在争议。IV PPI 与重症监护环境中的医院获得性肺炎以及肝硬化患者的自发性细菌性腹膜炎有关。本文讨论了 IV PPI 在不同临床情况下的应用、争议以及合理使用的问题。
