埃索美拉唑对体外循环心脏手术应激性溃疡保护作用的临床观察  

Clinical observation on prevention of stress ulcer with esomeprazole in cardio-pulmonary bypass heart surgery

作　　者：饶丹[1] 张勤斌[1] 王嬿[1] 黄圆琴[1] 罗能贞[1] 陈绪发[1] 

机构地区：[1]武汉亚洲心脏病医院心脏科,430022

出　　处：《心肺血管病杂志》2011年第1期17-19,共3页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:探讨埃索美拉唑对体外循环(CPB)心脏手术应激性溃疡的保护作用。方法:208例在体外循环下行瓣膜成形术和/或瓣膜置换术的心脏瓣膜病及需行冠状动脉搭桥(CABG)术的冠心病患者及需行心脏矫治术的先天性心脏病(先心病)患者,随机分为2组,对照组96例给予常规治疗,埃索美拉唑组112例,术前给予口服埃索美拉唑片40 mg/d,1 w;术中静注埃索美拉唑注射液40 mg,1次/d;术后静注埃索美拉唑注射液40 mg/d,3 d;分别于术前测大便OB试验1次,术后4h、术后第1天、术后第2天测胃黏膜pH值(pHi)。结果:埃索美拉唑组手术后4 h、术后第1天术后第2天测胃黏膜pH值(pHi)分别为6.01±0.64,6.32±0.59及6.58±0.39,而对照组手术后4 h、术后第1天、术后第2天测胃黏膜pH值(pHi)分别为3.21±0.22,3.67±0.34及3.43±0.41,与对照组比较,埃索美拉唑组pHi值明显高于对照组(P<0.01)。结论:埃索美拉唑可预防CPB心脏手术应激性溃疡。Objective： To observe the prevention of stress ulcer with esomeprazole in cardio-pulmonary bypass（CPB） heart surgery.Methods：208 patients who suffered valvular heart disease were scheduled to val-voplasty and/or valve replacement surgery undergoing CPB and who suffered coronary heart disease（CHD） were scheduled to coronary artery bypass grafting（CABG） surgery undergoing CPB and who suffered congenital cardi-ovascular disease were scheduled to heart rectification surgery undergoing CPB.They were randomized into two groups.96 patients in the control group received routine therapy,the other 112 patients in esomeprazole group received esomeprazole 40 mg once daily for a week before operation,40mg intravenously before CPB and then 40mg intravenously once daily after operation for three days.Before operation we measured stool OB.After op-eration 4 hours,1 day,2 day we measured pH of gastric intramucosa（pHi）.Results：The pH of gastric intramu-cosa（pHi） in esomeprazole group after operation 4 hours,1 day,2 day were 6.01 ± 0.64,6.32 ± 0.59 and 6.58 ± 0.39.And the pH of gastric intramucosa（pHi） in control group after operation 4 hours,1 day,2 day were 3.21 ± 0.22,3.67 ± 0.34 and 3.43 ± 0.41 Compared with those in control group,the pH of gastric in-tramucosa（pHi） in esomeprazole group were significantly higher than that in control group.Conclusion： Es-omeprazole can prevent stress ulcer in heart surgery undergoing CPB.

关 键 词：埃索美拉唑 体外循环 心脏外科手术 应激性溃疡 胃肠道保护 

分 类 号：R541[医药卫生—心血管疾病]