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首页> 外文期刊>Toxicological reviews >Do corticosteroids prevent oesophageal stricture after corrosive ingestion?
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Do corticosteroids prevent oesophageal stricture after corrosive ingestion?

机译：腐蚀性摄入后，皮质类固醇能预防食道狭窄吗？

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The most serious complication of corrosive damage to the oesophagus besides perforation is stricture formation. The role of corticosteroids in preventing corrosive-induced strictures is controversial. This review evaluates the usefulness of corticosteroid treatment by critically assessing clinical reports published between 1991 and 2004 in the English, German, French and Spanish literature. Inclusion criteria were the presence of second- or third-degree oesophageal injuries documented by endoscopy and management involving either at least an 8-day course of corticosteroids or no steroid therapy. Ten studies with a total of 572 patients fulfilled the inclusion criteria: six studies employed corticosteroids, two studies did not use corticosteroids, and two studies compared the outcome with and without corticosteroid treatment. In those patients with second-degree burns, the incidence of stricture in the corticosteroid-treated patients was 13.8% and in the non-corticosteroid-treated patients was 6.3%. In those patients with third-degree burns, significantly worse results were found in the corticosteroid-treated group (71.0%) than in the non-corticosteroid-treated group (23.1%). As all studies did not separate second- and third-degree burns, re-analysis of the outcome was undertaken. In the 305 patients treated with corticosteroids, 35.1% developed strictures, whereas 33.3% of the 267 non-corticosteroid-treated patients developed strictures. These data suggest that systemic corticosteroids are not beneficial for second- and third-degree corrosive oesophageal burns. Therefore, the use of corticosteroids in the management of corrosive ingestions should be abandoned as they do not prevent the development of strictures and may lead to the development of serious adverse effects.
机译：除了穿孔以外，对食道的腐蚀破坏最严重的并发症是狭窄的形成。皮质类固醇在预防腐蚀引起的狭窄中的作用是有争议的。这篇综述通过严格评估1991年至2004年间在英语，德语，法语和西班牙语文献中发表的临床报告，评估了皮质类固醇治疗的有效性。纳入标准是通过内窥镜检查和处理记录到的二级或三级食管损伤，涉及至少8天的皮质类固醇疗程或无类固醇疗法。共有572名患者的10项研究符合纳入标准：6项研究使用皮质类固醇，两项研究未使用皮质类固醇，两项研究比较了使用和不使用皮质类固醇治疗的结果。在那些有二级烧伤的患者中，接受皮质类固醇激素治疗的患者狭窄的发生率为13.8％，而未经皮质类固醇激素治疗的患者为狭窄的6.3％。在那些有三度烧伤的患者中，皮质类固醇治疗组（71.0％）的结果明显比非皮质类固醇治疗组（23.1％）差。由于所有研究均未将二度和三度烧伤分开，因此对结果进行了重新分析。在305名接受皮质类固醇激素治疗的患者中，有35.1％出现狭窄，而267名未经皮质类固醇激素治疗的患者中有33.3％出现狭窄。这些数据表明，全身性皮质类固醇激素对二度和三度腐蚀性食管烧伤无益。因此，应放弃使用皮质类固醇用于腐蚀性摄入的管理，因为它们不会阻止狭窄的发展，并可能导致严重的不良反应。

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