应激性溃疡药物预防的国内外指南分析.pdfVIP

2242 West China Medical Journal Vol.29 No.12 Dec. 2014 2014 29 65 H2 H2 ADOI:10.7507/1002-0179 Analysis of Guidelines for Stress Ulcer Drug Prophylaxis in and out of ChinaXIAO Gui-rong, WU Xin-ya, XU Ting. Department of Pharmacy, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China Corresponding author: XU Ting, E-mail: tingx2009@163.com Abstract Objective To research on the advances of stress ulcer drug prophylaxis. MethodsGuidelines for stress ulcer prophylaxis in and out of China were searched and analyzed. Risk factors for stress ulcer, recommended prevention drugs and safety of medicines were summarized. ResultsThe risk factors for stress ulcer included mechanical ventilation, coagulopathy, severe sepsis, multiple organ failure, shock, severe head injury, burns, major trauma, older than 65 and drug use. The recommended prevention drugs included proton pump inhibitors, H2-receptor antagonist and misoprostol, which played a role in the reduction of bleeding in intensive care units. However, recommended drugs had little function in the reduction of bleeding in general patients outside the intensive care units, which was even not recommended or supported in the clinical literature. Related adverse effects of these drugs also needed careful consideration. ConclusionsExistence of risk factors for stress ulcer does not necessarily indicate the use of preventive drugs. Drug prophylaxis is used only for critically ill patients. This vie