大剂量奥美拉唑治疗重症脑病致上消化道出血的疗效观察  

Observation of curative effect of large dose of omeprazole on stress upper digestive tract bleeding in the neurosurgical patients with severe cerebral diseases

作　　者：胡学安[1] 费舟[1] 李兵[1] 林伟[1] 胡世颉[1] 杨黎[1] 

机构地区：[1]第四军医大学西京医院神经外科,西安710032

出　　处：《中国临床神经外科杂志》2012年第1期18-20,共3页Chinese Journal of Clinical Neurosurgery

基　　金：陕西省自然科学基金(NO:2010JM4029)

摘　　要：目的探讨大剂量奥美拉唑对重症脑病并发应激性胃黏膜损害致上消化道出血的临床疗效。方法将2006年6月至2008年12月收治的重症脑病并发应激性胃黏膜损害致上消化道出血的272例患者随机分为两组:常规剂量奥美拉唑治疗组(A组,132例)和大剂量奥美拉唑治疗组(B组,140例)。另有C组为西咪替丁治疗组(76例)。观察各组治疗3d后应激性胃黏膜损害致上消化道出血的治疗效果。结果治疗3d后,A、B、C三组胃液潜血试验转阴率分别为53.79%、86.43%、26.32%,抑酸率(胃酸pH值≥6)分别为67.42%、95.00%、38.16%;无论是胃液潜血试验转阴率,还是抑酸率,B组均明显优于A组和C组(P<0.01)。结论大剂量奥美拉唑能有效地控制应激性上消化道出血。Objective To observe the curative effect of large dose of omeprazole on stress upper digestive tract bleeding in the neurosurgical patients with severe cerebral diseases. Methods Two hundred and seventy-two patients with stress upper digestive tract bleeding caused by severe cerebral diseases who were treated from June, 2006 to December, 2008 were randomly divided into 2 groups, i. e. groups A （132 cases） and B （140 cases）. All the patients in group A were treated by routine dose of omeprazole and ones in group B by large dose of omeprazole. There were 76 patients with stress upper digestive tract bleeding caused by severe cerebral diseases who were treated by cimetidine from December, 2005 to December, 2007 in group C. The curative effects of the upper digestive tract bleeding were observed 3 days after the treatment. Results The rates of negative occult blood test of the gastric juice in group A, B and C were 53.79%, 86.43% and 26.32% respectively. The inhibitory rate of the gastric acid （gastric juice pH ≥ 6） in group A, B and C were 67.42%, 95.00% and 38.16% respectively. There were significantly differences in the rates of the negative occult blood test and inhibitory rates of the gastric acid among A, B and C groups （ P 0.01）. Conclusion The curative effect of large dose of omeprazole on the stress upper digestive tract bleeding is good in the neurosurgical patients with severe cerebral disease.

关 键 词：奥美拉唑 重症脑病 应激性胃黏膜损害 上消化道出血 

分 类 号：R573.2[医药卫生—消化系统] R975.2[医药卫生—内科学]