Hirschl M
Neurochirurgischen Universitätsklinik Wien.
Wien Med Wochenschr. 1988 Mar 15;138(5):97-101.
Inspite of the controversial opinions on the ulcerogenicity of corticosteroids, an accompanying ulcus preventive therapy in all patients receiving high-dosage dexamethasone is carried out at the Neurological University Clinic, Vienna. A total of 120 patients suffering from brain tumors was included in this study. In consecutive order of their admission to the clinic, patients received sucralfate (4 g/day), ranitidinhydrochloride (336 mg/day), or raniditinhydrochloride and pirenzepindihydrochloride (100 mg/day), respectively. However, patient groups were comparable with regard to age- and sex-distribution, duration of therapy, perioperative circumstances and average cortisone dosage. Clinical investigations were carried out according to the standard manner. Laboratory controls were done at the entry of the patient, perioperative and within a postoperative period of 5 to 7 days. In all three patient groups clinical findings and subjective complaints were not different. Typical gastrointestinal symptoms in conjunction with a positive hemoccult-test was found in one patient. Medication-caused side effects and incompatibilities never were observed. A sufficient gastric protection was achieved regardless of the different mechanisms of actions of the various drugs administered. Metabolism-, fluid- and electrolyte disturbances are--apart from the neurological and neurosurgical complications--the main problems in these patients.
尽管关于皮质类固醇的致溃疡作用存在争议性观点,但维也纳神经大学诊所对所有接受高剂量地塞米松治疗的患者都进行了相应的溃疡预防治疗。本研究共纳入了120例脑肿瘤患者。按照患者入院的先后顺序,他们分别接受了硫糖铝(4克/天)、盐酸雷尼替丁(336毫克/天)或盐酸雷尼替丁与盐酸哌仑西平(100毫克/天)治疗。然而,患者组在年龄和性别分布、治疗持续时间、围手术期情况以及平均皮质醇剂量方面具有可比性。临床研究按照标准方式进行。实验室检查在患者入院时、围手术期以及术后5至7天内进行。在所有三个患者组中,临床发现和主观症状并无差异。仅1例患者出现了伴有潜血试验阳性的典型胃肠道症状。从未观察到药物引起的副作用和不相容性。无论所使用的各种药物作用机制如何不同,均实现了充分的胃保护。除了神经和神经外科并发症外,代谢、液体和电解质紊乱是这些患者的主要问题。