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作 者:施乙飞[1] 韩建阁[1] 蒋大中[1] 王国林[2]
机构地区:[1]天津市胸科医院麻醉科,300051 [2]天津医科大学第一附属医院总医院
出 处:《中国现代医药杂志》2006年第11期63-64,共2页Modern Medicine Journal of China
摘 要:目的观察奥美拉唑(OME)在非体外循环心脏不停跳冠脉搭桥术(OPCAB)中对患者胃保护作用。方法OPCAB患者63例,随机分为观察组(O组)33例和对照组(C组)30例。O组患者于气管插管后予以OME40mg加生理盐水100ml静脉滴注,滴注时间约40min。C组于同一时间,采用同样方法滴注生理盐水100ml,作为观察对照。两组患者分别于气管插管后(T1)、开胸后(T2)、开胸后40min(T3)、80min(T4)、120min(T5)、关胸时(T6)等6个时点测定胃内pH值,并于术后第1、2天随访患者是否有与胃粘膜损伤相关的恶心、呕吐、胃胀、潜血及出血等事件发生。结果O组6个时点胃液pH值均明显高于基础值(P<0.05或P<0.01),除T1外,两组各时点pH值差异显著(P<0.05或P<0.01)。与胃粘膜损伤相关的恶心、呕吐、胃胀、潜血及出血等事件,两组间也具有明显差别。结论实施OPCAB术的患者在气管插管后静脉滴注OME,可明显提高术中胃液pH值,具有胃保护作用,有效减少胃部并发症。Objective To observe the effect of Omeprazole (OME) on protection of gastric mucosal injury in off-pump coronary atery bypass surgery (OPCAB) . Methods Sixty-three patients undergoing OPCAB were randomized into the OME group (O, 33 cases) and the control group (C, 30 cases) . The O group received OME 40mg intravenously after intubation and the controls receive same volume of NS. Intragastic PH were recorded immediately from all patients just after intubation (T1), time on skin incision (T2), and 40 (T3), 80 (T4) and 120min (T5) after skin incision, the end of surgery (T6). Gastric mucosal injury relative syndom were recorded one & two days after operation. Results Intragastric pH was significantly lower in proup O than that in group C at all time points except at T1. There was significant difference between the two groups in the incidents of gastric mucosal injury. Conclusion OME raises intragastric pH in OPCAB and limits gastric mucosal injury relative complications.
关 键 词:奥美拉唑 非体外循环下冠状动脉搭桥术 胃粘膜损伤
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