胃黏膜pH值监测早期判断危重患者预后的探讨  

Study on the clinical significance of the gastric mucosal pH in early prognosis on critical patients

作　　者：吴歆[1] 宋越红[1] 

机构地区：[1]广西壮族自治区人民医院,南宁530021

出　　处：《广西医学》2004年第11期1611-1613,共3页Guangxi Medical Journal

摘　　要：目的　探讨胃黏膜pH(pHi)值监测对早期判断危重患者预后临床意义。方法　用胃张力仪测量 34例急诊ICU患者的胃黏膜下pH值 (pHi) ,以早期判断预后 ,与APACHⅡ评分法进行分析比较。结果　 34例患者有入ICU后 12～ 72h死亡 14例 ,生存组与死亡组比较 ,在初入ICU时死亡组的胃黏膜pHi低于存活组 (P <0 0 5 ) ,而APACHⅡ评分与PaO2 无差异 ;入ICU后12h死亡组的胃黏膜pHi显著低于存活组 (P <0 0 1) ,APACHⅡ评分高于存活组 (P <0 0 5 ) ,PaO2 则低于存活组 (P <0 0 5 )。本组患者有 7例发生MODS ,与未发生MODS组比较 ,APACHⅡ评分显著增高 (P <0 0 1) ,胃黏膜pHi显著降低 (P <0 0 5 )。结论　胃黏膜pHi作为一个间接测定局部组织氧合情况的指标对早期判断患者的预后有重要意义。Objective To study the clinical significance of the gastric mucosal pH (pHi) in early prognosis on critical patients.Methods Texts had been done on the gastric mucosal pHi of 34 critical patients in the Emergency ICU of our hospital by gastric tonometer to early prognose on these patients,and then compare with Acute Physilolgic and Chronic Health Evaluation (APACH Ⅱ).Results Among the 34 cases,14 cases died within 12h to 72h in ICU.Comparing dead and survival group,in the beginning in ICU,the results of pHi were different(P<0.05),but the APACH Ⅱ and PaO 2 were the same.After in ICU for 12h,comparing with the two group,the results of pHi were significantly different (P<0.01),the APACH Ⅱ and PaO 2 were different (P<0.05).7 cases among these 34 cases suffered from Multiple Organ Dysfunction (MODS).Comparing with the other group,APACH Ⅱ in MODS group were significantly higher (P<0.01),while pHi were lower(P< 0.05). Conclusions As an early detector of ischemia of internal organs,the gastric mucosal pH (pHi) has important clinical significance in early prognosis on critical patients.

关 键 词：胃黏膜 早期 危重患者 预后 ICU 死亡 存活 结论 判断 评分 

分 类 号：R573[医药卫生—消化系统] R563[医药卫生—内科学]