Pediatric Gastroenterology and Hepatology Research Center, Pediatrics Centre of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
Postgraduate Programme in Collective Health, Federal University of Maranhão, Rua Barão de Itapary, 155, São Luís - MA, Centro, Brazil.
Eur J Pediatr. 2023 Jun;182(6):2591-2596. doi: 10.1007/s00431-023-04924-2. Epub 2023 Mar 20.
Ingestion of caustic agents by children is a serious health issue that can affect the patient for the rest of his life. The role of sucralfate in preventing stricture caused by caustic agents is controversial, and limited studies have been conducted in this field. We aimed to investigate the effect of sucralfate on preventing esophageal stricture in children. Sixty children with mean age of 36.69 ± 20.50 months and grade II B esophageal burns due to ingestion of caustic agents were enrolled in the study. In the intervention group, in addition to the usual treatment, sucralfate was administered orally at a dose of 80 mg/kg every 2 h for 3 days. For the control group, only the usual treatment was prescribed. Stricture development was compared between groups based on endoscopic and radiologic findings. Of the 60 patients enrolled in the study, 53 were examined. The incidence of esophageal stricture in the intervention group was significantly lower than in the control group (37% versus 67%, P-value = 0.042). In addition, the odds of esophageal stricture after sucralfate intervention was significantly reduced after adjustment for potential confounders (OR = 0.198, P-value = 0.031). Conclusions: The results of this study showed that sucralfate may reduce the development of esophageal stricture in children when used to manage IIB esophageal burns due to ingestion of caustic agents. What is Known: • Ingestion of caustic agents by children is a serious health issue that can affect the patient for the rest of his life. • The role of sucralfate in preventing stricture caused by caustic agents is controversial and limited studies have been conducted in this field. What is New: • It seems that sucralfate significantly reduces the incidence of esophageal stricture following the ingestion of caustic agents in children compared to the control group. • We believe that the prognosis may be improved and the risk of stricture formation may be reduced with high doses of sucralfate therapy in grade IIB esophageal injury.
儿童吞食腐蚀性物质是一个严重的健康问题，可能会影响患者的余生。硫糖铝在预防腐蚀性物质引起的狭窄方面的作用存在争议，并且在该领域进行的研究有限。我们旨在研究硫糖铝对预防儿童食管狭窄的影响。
这项研究纳入了 60 名因吞食腐蚀性物质而导致 IIB 级食管烧伤、平均年龄为 36.69±20.50 个月的儿童。在干预组中，除了常规治疗外，硫糖铝以 80mg/kg 的剂量口服，每 2 小时 1 次，共 3 天。在对照组中，仅开具常规治疗处方。根据内镜和放射学检查结果比较两组狭窄的发展情况。
在这项研究中，60 名患者中有 53 名接受了检查。干预组食管狭窄的发生率明显低于对照组（37%比 67%，P 值=0.042）。此外，在调整了潜在混杂因素后，硫糖铝干预后发生食管狭窄的可能性显著降低（OR=0.198，P 值=0.031）。
总之，该研究结果表明，在治疗因吞食腐蚀性物质导致的 IIB 级食管烧伤时，硫糖铝可能会降低儿童食管狭窄的发生。
