Bretagne J F, Raoul J L
Service d'Hépato-Gastroénterologie, Centre Hospitalier et Universitaire Pontchaillou, Rennes, France.
Dig Dis. 1995 Jan;13 Suppl 1:89-105. doi: 10.1159/000171529.
The risk of gastrointestinal bleeding or perforation during NSAID use is unquestionably increased. The need for emergency surgery as well as mortality is also increased in NSAID users as compared to nonusers. However, the magnitude of these risks still remains imprecise. There is a lot of controversy about the role of predisposing factors such as age, sex, past history of peptic ulcer disease, dyspepsia or infection by Helicobacter pylori. The bleeding risk seems to be related to NSAID dosage, but not to the duration of treatment. The location most at risk varies from one study to another with no significant difference between gastric and duodenal ulcers. Bleeding severity or mortality rate do not differ according to whether NSAIDs are used or not. General treatment principles of peptic ulcer bleeding as well as the role of endoscopic hemostasis, drug therapy or surgery are emphasized. The role of subsequent treatment after hemostasis and the rules for prophylaxis are also discussed.
使用非甾体抗炎药（NSAID）期间发生胃肠道出血或穿孔的风险无疑会增加。与未使用NSAID的人相比，NSAID使用者进行急诊手术的必要性以及死亡率也会增加。然而，这些风险的程度仍不明确。关于年龄、性别、消化性溃疡病史、消化不良或幽门螺杆菌感染等易感因素的作用存在很多争议。出血风险似乎与NSAID剂量有关，而与治疗持续时间无关。不同研究中风险最高的部位各不相同，胃溃疡和十二指肠溃疡之间无显著差异。无论是否使用NSAID，出血严重程度或死亡率并无差异。文中强调了消化性溃疡出血的一般治疗原则以及内镜止血、药物治疗或手术的作用。还讨论了止血后的后续治疗作用和预防规则。
