Gonzalez E R, Morkunas A R
Drug Intell Clin Pharm. 1985 Nov;19(11):807-11. doi: 10.1177/106002808501901102.
The near universal occurrence of stress ulcers in critically ill patients emphasizes the need for early and effective prophylaxis. Intraluminal gastric acidity, ischemic insult to the bowel, and the presence of stress factors are the major precipitants of stress ulcers. The use of H2-receptor antagonists vs. antacid titration for stress ulcer prophylaxis is reviewed. The goals of preventive therapy are to eliminate the stress factors and to maintain intragastric pH greater than 5. Hourly gastric pH monitoring and antacid titration are the mainstay of stress ulcer prophylaxis, with high potency antacids being the preferred agents. H2-receptor antagonists may serve as adjuncts in patients requiring large doses of antacids or having acid-base abnormalities from high gastric output states.
危重症患者中应激性溃疡几乎普遍存在，这凸显了早期有效预防的必要性。胃内酸度、肠道缺血性损伤以及应激因素的存在是应激性溃疡的主要促发因素。本文综述了使用H2受体拮抗剂与抗酸剂滴定法预防应激性溃疡的情况。预防性治疗的目标是消除应激因素并使胃内pH值维持在5以上。每小时监测胃pH值并进行抗酸剂滴定是应激性溃疡预防的主要方法，高效抗酸剂是首选药物。对于需要大剂量抗酸剂或因高胃输出状态出现酸碱异常的患者，H2受体拮抗剂可作为辅助用药。
