Razafimahefa H, Mouterde O, Devaux A M
Service de réanimation pédiatrique, hôpital Charles-Nicolle, Rouen, France.
Arch Pediatr. 1997 Jul;4(7):659-61. doi: 10.1016/s0929-693x(97)83369-6.
Sucralfate is widely used in stress bleeding prophylaxis in intensive care units as it causes relatively few side effects. Its use in patients with risk factors may lead to the formation of esophageal bezoar. We describe the first known pediatric case of sucralfate esophageal bezoar.
A 11-year-old girl presented with severe encephalitis complicated by seizures. She was treated in an intensive care unit by restrictive hydration associated with sucralfate, morphinic compound, phenobarbital and curare. At day 10, enteral feeding through a nasogastric tube was started. Five days later, an esophageal bezoar was diagnosed, which disappeared after discontinuing sucralfate, morphinic compound, curare and enteral feeding.
Risk factors, similar to those reported in adults with esophageal bezoars, were found in this patient ie, plurimedication, dehydration, impaired gastric motility. Caution should be taken when combining enteral feeding and sucralfate whenever any additional risk factor is present.
硫糖铝因其副作用相对较少,在重症监护病房中广泛用于应激性出血的预防。在有危险因素的患者中使用硫糖铝可能会导致食管粪石形成。我们描述了首例已知的小儿硫糖铝食管粪石病例。
一名11岁女孩因重症脑炎并发癫痫发作。她在重症监护病房接受治疗,治疗措施包括限制补液,并联合使用硫糖铝、含吗啡化合物、苯巴比妥和箭毒。在第10天,开始通过鼻胃管进行肠内喂养。五天后,诊断出食管粪石,在停用硫糖铝、含吗啡化合物、箭毒和肠内喂养后,食管粪石消失。
在该患者中发现了与成人食管粪石患者中报道的类似危险因素,即多种药物联用、脱水、胃动力受损。当存在任何其他危险因素时,在肠内喂养与硫糖铝联合使用时应谨慎。