Successful Treatment of Radiation-Induced Hemorrhagic Gastritis by Prednisolone

以類固醇成功治癒放射線治療導致之出血性胃炎：一病例報告

蔡峰偉(Feng-Woei Tsay) ； 羅錦河(Gin-Ho Lo) ； 黎國洪(Kwok-Hung Lai) ； 林俊谷(Chiun-Ku Lin) ； 陳海雄(Hoi-Hung Chen) ； 許秉毅(Ping-I Hsu)

《內科學誌》 17卷1期 (2006/02) Pp. 39-42

https://doi.org/10.6314/JIMT.2006.17(1).07

摘要

臨床上因放射線治療導致的出血性胃炎並不常見，目前亦無有效的治療方式。本文報導一位53歲的膽管癌女性病患在接受放射線治療後，發生出血性腸胃炎，合併有反覆性的解黑便及出血性休克。在以內視鏡腎上腺素局部注射合併氫離子阻斷劑藥物治療下，仍有反覆出血的情形。在氫氣電漿凝固止血治療法無法獲得的情況下，最後我們嘗試著以高劑量口服類固醇施以治療。結果病患的病情迅速改善，於投藥第二天後便未再有出血情況，且於二週後順利出院。在為期五個月的門診追蹤期間，並未再有出血情形。顯示類固醇對於控制某些放射治療後所引起的出血性胃腸炎有很好的效果。

關鍵字

Radiation ； Hemorrhagic gastritis ； Prednisolone

並列摘要

Radiation-induced gastritis is a rare cause of gastrointestinal bleeding. Currently, the standard method for treatment of radiation-induced hemorrhagic gastritis has not been established. We presented a 53-year-old female patient with hemorrhagic gastritis and recurrent melena following external radiotherapy for cholangiocarcinoma. Endoscopic local injection and anti-secretary therapy were performed for hemostasis, but the symptoms still occurred off and on. Finally, high dose prednisolone was prescribed to her. The response was dramatic, and bleeding stopped 2 days later. She was then discharged with stable condition. There was no gastrointestinal bleeding in subsequent 5-month follow-up period. In conclusion, steroid therapy can effectively treat some patients with radiation-induced hemorrhagic gastroenteritis.