重型颅脑损伤后应激性溃疡防治与胃肠道感染的相关性及对策  

Relation between treatment of stress gastric ulcer and gastrointestinal infection in severe craniocerebral injury patients and the countermeasures

作　　者：钟天安[1] 王建奇[2] 姚鹏飞[2] 徐越[2] 贾军[1] 张浚[1] 

机构地区：[1]广东省深圳市龙岗中心医院神经外科,518116 [2]南方医科大学珠江医院神经外科,广州510282

出　　处：《中华神经医学杂志》2006年第8期823-825,共3页Chinese Journal of Neuromedicine

基　　金：深圳市龙岗区科学基金[深龙科(2003)21号]

摘　　要：目的探讨重型颅脑损伤患者应用洛赛克对应激性溃疡进行防治与胃肠道感染几率增加之间的关系及治疗对策。方法回顾近3年来我院收治的重型颅脑损伤并存活30 d以上病人176例,测定不同时间胃液pH值并分析防治应激性溃疡与发生胃肠道感染的相关性以及相应对策。结果在126例持续应用洛赛克的患者中,持续应用＞7 d的患者胃肠道感染发生率明显高于持续应用≤7 d的病人。其余50例间隔应用洛赛克患者与126例持续应用洛赛克患者相比,应激性溃疡发生率无明显差别,但间隔应用洛赛克患者胃肠道感染发生率较持续应用洛赛克＞7 d的患者明显下降。结论重型颅脑损伤患者应激性溃疡防治＞7 d者,由于胃酸分泌严重抑制,增加胃肠道感染发生率。间隔性应用洛赛克治疗在抑制胃酸分泌,减少应激性溃疡发生的同时,可明显减少胃肠道感染的发生。Objective To investigate whether the treatment of stress gastric ulcer with omeprazol increase the susceptibility to gastrointestinal infection in severe craniocerebral injury patients and to explore the effective countermeasures. Methods A total of 176 cases with severe brain injury which survived more than 30 d in recent 3 years were analyzed to find out the relation between stress gastric ulcer treatment and gastrointestinal infection in these cases. The pH value of gastric juice was also monitored at different time. Results Among the 126 cases accepting continuously omeprazol, the incidence rate of gastrointestinal infection in the ones with 〉 7 d administration of omeprazol was much lower than the ones with ≤7 d. The incidence rate of gastrointestinal infection in the other 50 cases with interval use of omeprazol was also much lower than the ones with 〉 7 d continuous administration of omeprazol. Conclusion In severe craniocerebral injury patients with 〉 7 d continuous administration of omeprazol, the gastric acid excreting was severely depressed, so that the incidence of gastrointestinal infection was increased. The interval use of omeprazol not only controlled the gastric acid secreting and improved the stress gastric ulcer, but also reduced the incidence of gastrointestinal infection.

关 键 词：颅脑损伤 应激性溃疡 胃肠道感染 

分 类 号：R651[医药卫生—外科学] R57[医药卫生—临床医学]