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A prospective randomized controlled trial of omeprazole for preventing esophageal stricture in grade 2b and 3a corrosive esophageal injuries

奥美拉唑预防 2b 级和 3a 级食管腐蚀性损伤食管狭窄的前瞻性随机对照试验

  • 影响因子:3.18
  • DOI:10.1007/s00464-020-07707-0
  • 作者列表:"Mahawongkajit, Prasit","Tomtitchong, Prakitpunthu","Boochangkool, Nuttorn","Mingmalairak, Chatchai","Awsakulsutthi, Surajit","Havanond, Chittinad
  • 发表时间:2020-06-15
Abstract

Objectives Esophageal stricture is a significant complication of grade 2b and 3a esophageal injuries and causes much patient suffering. Preventing strictures would be beneficial to patients but there are currently no proven effective drugs. This study aimed to evaluate the effect of omeprazole for preventing esophageal stricture in adults with grade 2b and 3a corrosive esophageal injuries. Methods This study was an open single-center prospective randomized controlled trial that took place from April 2018 to January 2020. Patients were randomized to standard treatment or 80 mg/day intravenously × 3 days followed by 40 mg/day orally for 4 weeks. They were endoscoped at baseline and 4 weeks post discharge. Strictures were confirmed radiologically. Results 20 patients were enrolled: 15 with grade 2b and five with grade 3a injuries. Standard care and omeprazole groups numbered 10 each. At 1 month, seven and two patients developed strictures in the standard and omeprazole groups, respectively, p  =  0.024 , for a risk reduction of 71.4%. Conclusions Omeprazole reduced the risk of short-term developing esophageal strictures following grade 2b and 3a corrosive esophageal injuries. Larger studies are needed to reconfirm this finding. Thai Clinical Trials Registry (TCTR) number TCTR20190504001

摘要

目的食管狭窄是 2b级和 3a级食管损伤的严重并发症,给患者带来很大痛苦。预防狭窄对患者有益,但目前尚无有效的药物。本研究旨在评价奥美拉唑预防成人 2b级和 3a级食管腐蚀性损伤食管狭窄的效果。方法本研究为开放性单中心前瞻性随机对照试验,时间为 2018 年 4 月至 2020 年 1 月。患者随机接受标准治疗或 80 mg/天静脉注射 × 3 天,随后口服 40 mg/天,共 4 周。在基线和出院后 4 周进行内镜检查。放射学证实狭窄。结果入选 20 例患者: 2b级 15 例,3a级 5 例。标准护理和奥美拉唑组各编号 10。在 1 个月时,标准组和奥美拉唑组分别有 7 例和 2 例患者发生狭窄,p = 0.024,风险降低 71.4%。结论奥美拉唑可降低 2b级和 3a级食管腐蚀性损伤后短期发生食管狭窄的风险。需要更大的研究来再次证实这一发现。泰国临床试验注册中心 (TCTR) 编号TCTR20190504001

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影响因子:1.24
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作者列表:["Shang L","Pei QS","Xu D","Liu JY","Liu J"]

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作者列表:["Campos VJ","Mazzini GS","Juchem JF","Gurski RR"]

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