Stress ulcer disease in the burned patient
Stress ulcer disease in the burned patient
复制标题
烧伤患者的应激性溃疡病
DOI：
10.1007/bf01658293
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发表时间：
2005
影响因子：
2.6
通讯作者：
Cleon W. Goodwin Jr.
中科院分区：
文献类型：
--
作者：
Basil A. Pruitt Jr.;Cleon W. Goodwin Jr.
大面积烧伤患者应激诱导的胃和十二指肠溃疡，也称为柯林溃疡，是由分泌酸的粘膜屏障缺陷引起的。这种缺陷的病因至少部分与粘膜缺血有关，低血压、败血症和缺氧会加重粘膜缺血。抗酸剂和西咪替丁的早期预防性给药，无论是单独或组合，显着减少了这些病变的危及生命的并发症的发生。当预防措施失败或未使用并且发生大出血或穿孔时，柯林溃疡的这些并发症似乎最好通过胃切除术联合迷走神经切断术来治疗。
Stress-induced ulcers of the stomach and duodenum in massively burned patients, otherwise known as Curling's ulcers, result from a defect in the mucosal barrier to secreted acid. The etiology of this defect is related, at least in part, to mucosal ischemia, which is aggravated by hypotension, sepsis, and hypoxia. Early prophylactic administration of antacids and cimetidine, either singly or in combination, has significantly reduced the occurrence of the life-threatening complications of these lesions. When preventive measures have failed or have not been utilized and massive bleeding or perforation has occurred, these complications of Curling's ulcer appear to be best treated by gastric resection combined with vagotomy.