Kitamura N, Hirasawa H
Department of Emergency and Critical Care Medicine, Chiba University School of Medicine.
Nihon Rinsho. 1998 Sep;56(9):2396-400.
Today in critically ill patients the frequency of major stress ulceration related bleeding (SURB) has decreased. However this syndrome has not totally disappeared and its mortality remains very high once it develops. It's high mortality seems to be due to the facts that pathogenesis of SURB is mucosal ischemia resulting from splanchnic hypoperfusion in the setting of various insults in the ICU and that SURB reflects gut failure as a part of multiple organ failure (MOF). Therefore in the prevention of SURB, the optimization of tissue oxygen metabolism in splanchnic area must be considered in addition to the common prophylactic measures such as decreasing or neutralizing gastric acid and protecting gut mucosa.
如今,在危重症患者中,与严重应激性溃疡相关的出血(SURB)发生率有所下降。然而,这种综合征并未完全消失,一旦发生,其死亡率仍然很高。其高死亡率似乎是由于以下事实:SURB的发病机制是在重症监护病房(ICU)各种损伤情况下,内脏低灌注导致黏膜缺血,且SURB反映了作为多器官功能衰竭(MOF)一部分的肠道功能衰竭。因此,在预防SURB时,除了诸如减少或中和胃酸以及保护肠黏膜等常见的预防措施外,还必须考虑优化内脏区域的组织氧代谢。