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药物性食管溃疡在青少年人群中的表现:来自中国台湾中部某单一医学中心的经验。

Drug-Induced Esophageal Ulcer in Adolescent Population: Experience at a Single Medical Center in Central Taiwan.

机构信息

Department of Pediatrics, Tungs' Taichung MetroHarbor Hospital, No. 699, Sec. 8, Taiwan Blvd., Wuqi Dist., Taichung City 435403, Taiwan.

Division of Pediatric Hepatology and Gastroenterology, China Medical University Children's Hospital, China Medical University, No. 2, Yude Rd., North Dist., Taichung City 404327, Taiwan.

出版信息

Medicina (Kaunas). 2021 Nov 23;57(12):1286. doi: 10.3390/medicina57121286.

DOI:10.3390/medicina57121286
PMID:34946231
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8708022/
Abstract

: Drug-induced esophageal ulcer is caused by focal drug stimulation. It may occur in adults and children. Limited research is available in pediatric patients with drug-induced esophageal ulcer; therefore, we designed this study to determine the characteristics of this disease in this population. : Thirty-two pediatric patients diagnosed with drug-induced esophageal ulcers from a hospital database of upper gastrointestinal tract endoscopies were included. After treatment, patients were followed for 2 months after upper gastrointestinal endoscopy. : Female patients were predominant (56.2%/43.8%). The mean age of patients was 15.6 years (median, 16 years; interquartile range, 2 years). Doxycycline was administered in most cases (56.3%); other drugs were dicloxacillin, amoxicillin, clindamycin, L-arginine, and nonsteroidal anti-inflammatory drugs. Doxycycline was associated with kissing ulcers. Esophageal ulcers induced by nonsteroidal anti-inflammatory drugs were more often associated with gastric or duodenal ulcers. The most common location was the middle-third of the esophagus (78.1%). Patients were treated with proton pump inhibitors, sucralfate, or H2-blockers. The mean duration for which symptoms lasted was 9.2 days. No esophageal stricture was found in 24 patients who were followed for 2 months after upper gastrointestinal endoscopy. : The authors suggest informing patients to take medicine with enough water (approximately 100 mL) and enough time (15-30 min) before recumbency, especially high-risk drugs, such as doxycycline or nonsteroidal anti-inflammatory drugs.

摘要

药物性食管溃疡是由药物局部刺激引起的。它可发生于成人和儿童。目前针对儿童药物性食管溃疡的研究有限;因此,我们设计了这项研究,以确定该人群中该病的特征。

从医院上消化道内镜数据库中纳入了 32 例经诊断为药物性食管溃疡的儿科患者。在上消化道内镜检查后,对患者进行了 2 个月的随访。

女性患者居多(56.2%/43.8%)。患者的平均年龄为 15.6 岁(中位数 16 岁;四分位距 2 岁)。大多数情况下给予多西环素(56.3%);其他药物为双氯西林、阿莫西林、克林霉素、L-精氨酸和非甾体抗炎药。多西环素与接吻性溃疡有关。非甾体抗炎药引起的食管溃疡更常与胃或十二指肠溃疡有关。最常见的部位是食管中段(78.1%)。患者接受质子泵抑制剂、硫糖铝或 H2 阻滞剂治疗。症状持续的平均时间为 9.2 天。在上消化道内镜检查后随访 2 个月的 24 例患者中未发现食管狭窄。

作者建议告知患者在服用药物时要多喝水(约 100 毫升),并在躺下前有足够的时间(15-30 分钟),特别是高风险药物,如多西环素或非甾体抗炎药。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ff3/8708022/2f93de9a4bde/medicina-57-01286-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ff3/8708022/9a40e1e20e20/medicina-57-01286-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ff3/8708022/2f93de9a4bde/medicina-57-01286-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ff3/8708022/9a40e1e20e20/medicina-57-01286-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ff3/8708022/2f93de9a4bde/medicina-57-01286-g002.jpg

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Esophageal Dysphagia in Children: State of the Art and Proposal for a Symptom-Based Diagnostic Approach.儿童食管吞咽困难:最新进展及基于症状的诊断方法建议
Front Pediatr. 2022 Jun 24;10:885308. doi: 10.3389/fped.2022.885308. eCollection 2022.
Bol Med Hosp Infant Mex. 2020;77(1):38-41. doi: 10.24875/BMHIM.19000109.
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Clindamycin-Induced Esophageal Injury: Is It an Underdiagnosed Entity?克林霉素所致食管损伤:是一种诊断不足的疾病吗?
Clin Med Insights Case Rep. 2019 Dec 25;12:1179547619884055. doi: 10.1177/1179547619884055. eCollection 2019.
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