Matsumoto T, Kaibara N, Sugimachi K, Kawarada Y
Jpn J Surg. 1978 Dec;8(4):261-9. doi: 10.1007/BF02469408.
Unlike hemorrhage from peptic ulcer, surgical management for hemorrhage from stress ulcer is not necessarily successful on many occasions. Thus, the most important thing one can try is to prevent the development of this condition. Forty eight patients admitted to the Shock and Trauma Unit, Hahnemann Medical College and Hospital, who had a primary diagnosis of shock were divided into three groups: group 1 received the standard shock regimen plus large dose steroid therapy repeated every four hours for 36 hours; group 2 received the standard shock regimen plus small dose steroid therapy repeated every four hours for 96 hours; group 3 received the standard shock regimen without the addition of steroids. There was a 57.9 per cent incidence of acute gastric ulceration in those shock patients not treated with steroids (group 3) compared with 33.3 per cent incidence of gastric ulceration in group 2 and 5.9 per cent incidence in group 1. The use of pharmacologic doses of steroids early in the shock state for period of less than 36 hours seems to reduce the incidence of gastric ulceration and hemorrhage in low flow states associated with septic, cardiogenic and hemorrhagic shock.
与消化性溃疡出血不同，应激性溃疡出血的手术治疗在很多情况下不一定成功。因此，人们所能尝试的最重要的事情就是预防这种情况的发生。哈内曼医学院和医院休克与创伤科收治的48例初步诊断为休克的患者被分为三组：第一组接受标准休克治疗方案加每四小时重复一次的大剂量类固醇治疗，持续36小时；第二组接受标准休克治疗方案加每四小时重复一次的小剂量类固醇治疗，持续96小时；第三组接受不添加类固醇的标准休克治疗方案。未接受类固醇治疗的休克患者（第三组）急性胃溃疡的发生率为57.9%，而第二组胃溃疡的发生率为33.3%，第一组为5.9%。在休克状态早期使用药理剂量的类固醇且时间少于36小时，似乎可以降低与感染性、心源性和失血性休克相关的低流量状态下胃溃疡和出血的发生率。
