Department of Gastroenterology, Ankara Education and Research Hospital, Ankara, Turkey.
Dis Esophagus. 2013 Jan;26(1):22-6. doi: 10.1111/j.1442-2050.2011.01319.x. Epub 2012 Feb 14.
The ingestion of caustic substances may result in significant esophageal injury. There is no standard treatment protocol for esophageal injury and most patients are treated with a proton pump inhibitor or H2 antagonist. However, there is no clinical study evaluating the efficacy of omeprazole for caustic esophageal injury. A prospective study of 13 adult patients (>18 years of age) who were admitted to our hospital for caustic ingestion between May 2010 and June 2010 was conducted. Mucosal damage was graded using a modified endoscopic classification described by Zargar et al. Patients were treated with a proton pump inhibitor and maintained without oral intake until their condition was considered stable. Patients received omeprazole 80 mg in bolus IV, followed by continuous infusion of 8 mg/hour for 72 hours. A control endoscopy was performed 72 hours after admission. There was significant difference regarding endoscopic healing between the before and after omeprazole infusion (P = 0.004). There was no hospital mortality at the follow-up. Omeprazole may effectively be used in the acute phase treatment of caustic esophagus injuries.
腐蚀性物质的摄入可能导致严重的食管损伤。目前对于食管损伤尚无标准的治疗方案，大多数患者采用质子泵抑制剂或 H2 拮抗剂进行治疗。然而，目前尚无评估奥美拉唑治疗腐蚀性食管损伤疗效的临床研究。本研究对 2010 年 5 月至 6 月期间因腐蚀性物质摄入而入住我院的 13 例成年（>18 岁）患者进行了前瞻性研究。采用 Zargar 等人描述的改良内镜分级法对黏膜损伤进行分级。患者采用质子泵抑制剂治疗，并在病情稳定之前保持禁食。患者给予奥美拉唑 80 mg 静脉推注，随后以 8 mg/小时的速度持续输注 72 小时。在入院后 72 小时进行对照内镜检查。奥美拉唑输注前后内镜愈合情况有显著差异（P=0.004）。随访时无院内死亡病例。奥美拉唑可能有效地用于腐蚀性食管损伤的急性期治疗。
