药物相关性食管溃疡10例报道及文献荟萃分析  

A ten-case report and meta-analysis involving drug-related esophageal ulcers

作　　者：叶月芳 祝思慧[1,2] 朱羽琪 来志超 王仲略 吴建良[2] YE Yuefang;ZHU Sihui;ZHU Yuqi;LAI Zhichao;WANG Zhonglue;WU Jianliang(School of Clinical Medicine,Hangzhou Normal University,Hangzhou 311121,China;Department of Gastroenterology,The Affiliated Hospital of Hangzhou Normal University,Hangzhou 310015,China)

机构地区：[1]杭州师范大学临床医学院,浙江杭州311121 [2]杭州师范大学附属医院消化内科,浙江杭州310015

出　　处：《健康研究》2023年第4期468-471,共4页Health Research

基　　金：浙江省自然科学基金项目(LY16H030017);高层次留学回国人员在杭创新项目;杭州市科技发展计划项目(20120633B27)。

摘　　要：目的分析口服药物所致食管溃疡患者的临床资料、胃镜所见和病理表现,为临床提供依据。方法收集2017年12月—2020年12月杭州师范大学附属医院经胃镜诊断的食管溃疡病例190例,筛选有明确服药史且排除其他食管疾病的患者并进行随访,归纳总结其一般情况、服药名称、服药方式、临床症状、内镜表现、病理特点、治疗及预后;结合国内三大数据库的相关文献,进行药物相关性食管溃疡的荟萃分析。结果190例中筛选到药物相关性食管溃疡患者10例(5.26%),主要与口服药物方式不当有关。文献检索到80例,药物相关性食管溃疡患者可发生于任何年龄,男、女发生率大致相当(1.35∶1),引起溃疡的药物主要为抗生素、非甾体类抗炎药、激素、维生素等胶囊或片剂,溃疡部位大多发生于食管中段(72.5%),且多发(56.25%)较单发(37.5%)多见,预后大多良好。结论口服药物方法不当可导致食管溃疡,经正规治疗后可完全愈合。口服药物前宣教是预防其发生的关键。Objective To analyze the clinical data,gastroscopy findings,and pathological manifestations of patients with esophageal ulcers caused by oral medication and to provide a basis for clinical practice.Methods A total of 190 cases of esophageal ulcers were identified through gastroscopy at the Affiliated Hospital of Hangzhou Normal University between December 2017 and December 2020,with a clear history of oral medication use and absence of other esophageal disorders,followed up for further evaluation.Subsequently,a comprehensive summary was conducted on the general conditions,medication names and methods,clinical symptoms,endoscopic manifestations,pathological characteristics,treatment and prognosis of these cases.Additionally,a meta-analysis was performed by searching drug-related esophageal ulcer literature in three major domestic databases.Results Out of 190 cases,10 patients(5.26%)were diagnosed with drug-related esophageal ulcers,primarily due to improper oral medication techniques.Based on literature review,drug-induced esophageal ulcers can occur at any age and affect both genders equally(male-to-female ratio of approximately 1.35:1).The ulcers were primarily induced by capsules or tablets of antibiotics,non-steroidal anti-inflammatory drugs,hormones,and vitamins.Predominantly located in the middle segment of the esophagus(72.5%),multiple lesions(56.25%)outnumbered solitary ones(37.5%).Overall prognosis was favorable.Conclusions Improper administration of oral medication can result in the development of esophageal ulcers,which can be effectively treated with proper medical intervention.Pre-administration education regarding oral medication is crucial in preventing their occurrence.

关 键 词：食管溃疡 药物相关性 胃镜检查 

分 类 号：R571[医药卫生—消化系统]