早期胃肠道营养联合雷尼替丁预防重症脑卒中并发应激性溃疡出血的观察  

Preventive Effect of Early Gastrointestinal Nutrition(GN) in Combination with Ranitidine on Stress Ulcer Bleeding in Severe Stroke

作　　者：史雁[1] 

机构地区：[1]南昌市第二医院神经内科,南昌330006

出　　处：《实用临床医学（江西）》2012年第1期13-15,共3页Practical Clinical Medicine

摘　　要：目的探讨早期胃肠道营养联合雷尼替丁对重症脑卒中应激性溃疡患者的预防作用。方法将87例重症脑卒中患者按随机数字表法分为2组。治疗组44例,采用胃肠道营养支持联合雷尼替丁治疗;对照组43例,采用胃肠外营养支持治疗。治疗过程中出现应激性溃疡者给予抗酸药(质子泵抑制剂或组织胺受体抑制剂)处理。对2组应激性溃疡的发生情况进行比较。结果治疗组发生应激性溃疡出血9例(20.5%),对照组发生应激性溃疡出血16例(37.2%),2组比较差异有统计学意义(P<0.05)。应激性溃疡发生时间:87例患者住院7d内发生15例,住院8～14d发生7例,住院15～21d发生3例。经抢救后17例上消化道出血得到控制,死亡8例,其中治疗组死亡2例(4.5%),对照组死亡6例(14.0%),2组病死率比较差异有统计学意义(P<0.05)。结论早期胃肠道营养联合雷尼替丁鼻饲对重症脑卒中应激性溃疡有预防作用。Objective To explore the preventive effect of early gastrointestinal nutrition（GN） in combination with ranitidine on stress ulcer bleeding in the early stage of severe stroke.Methods Eighty-seven patients with severe stroke were randomly assigned to receive either parenteral nutrition support therapy（control group,n=43） or GN combined with ranitidine（treatment group,n=43）.Patients with stress ulcer were treated with antacids（proton pump inhibitors or histamine receptor antagonists） and the incidence of stress ulcer was compared between the two groups.Results The incidence of stress ulcer bleeding in treatment group（20.5%,9 patients） was significantly lower than that in control group（37.2%,16 patients）（P0.05）.Among the 87 patients,stress ulcer occurred within the first 7 hospital days in 15,during 8 to 14 hospital days in 7,and during 15 to 21 hospital days in 3.Seventeen patients obtained control of upper gastrointestinal bleeding after emergency treatment.However,2 patients in treatment group and 6 in control group died of complications.The death rate was significantly different between the two groups（P0.05）.Conclusion The combination of GN and ranitidine is effective in preventing stress ulcer in severe stroke.

关 键 词：早期胃肠内营养 雷尼替丁 预防 脑卒中 应激性溃疡 

分 类 号：R473.3[医药卫生—护理学]