常规静脉应用抑酸药物对重度颅脑损伤患者并发应激性胃黏膜损害的疗效观察  

Effect of intravenous injection of acid-suppressing drugs on patients with severe brain injury complicated with stress gastric mucosal damage

作　　者：徐晓峰 惠东伟 曹龙兴 

机构地区：[1]江苏张家港市第三人民医院神经外科,张家港215600

出　　处：《中国实用神经疾病杂志》2014年第11期25-27,共3页Chinese Journal of Practical Nervous Diseases

摘　　要：目的观察常规应用抑酸药物对重度颅脑损伤患者并发应激性胃黏膜损害的预防效果。方法选取2010-01—2013-06我院收治的60例重度颅脑损伤患者,依据治疗方法不同将其分为抑酸组和对照组各30例。对照组仅接受重度颅脑损伤基础治疗,抑酸组加用抑酸药物静脉注射。比较2组治疗前后的胃液pH值和红细胞数量、肠鸣音活跃或亢进和大便潜血阳性以及治疗前后血胃泌素水平。结果治疗后抑酸组胃液平均pH值明显高于对照组,胃液红细胞低于对照组(P<0.05);治疗后抑酸组肠鸣音活跃或亢进及大便潜血阳性的发生率分别为23.3%、13.3%,对照组分别为50.0%、36.7%,抑酸组患者明显少于对照组(P<0.05);治疗4d后抑酸组患者血胃泌素水平明显低于对照组(P<0.05)。结论重度颅脑损伤患者伤后早期常规静脉应用抑酸药物可明显降低胃黏膜损害发生率,建议临床推广应用。Objective To explore the effect of routine use of acid-suppressing drugs on patients with severe traumatic brain injury in the prevention of stress-induced gastric mucosal damage.Methods From January 2010 to June 2013 ,60 patients with severe traumatic brain injury in our hospital were divided into antacid group and control group according to the different methods of treatment ,each group had 30 cases.The control group received only basic treatment for severe traumatic brain injury , antacid group received intravenous injection of acid-suppressing drugs based on basic treatment.pH value and red blood cell count of gastric juice ,active or hyperactive bowel sounds ,and positive cases of fecal occult blood ,serum gastrin levels before and after treatment were compared.Results After treatment ,gastric pH value of the antacid group was significantly higher , red blood cells less than that of the control group （P〈0.05）.The incidence of active or hyperactive bowel sounds and positive cases of fecal occult blood were 23.3% and 13.3% respectively in the antacid group ,while they were 50.0% and 36.7% in the control group ,the incidence of antacid group was significantly less than that of the control group （P〈0.05）.Four days after treatment ,serum gastrin of the antacid group was significantly lower than that of the control group （P〈0.05）.Conclusion Early intravenous injection of antacid drugs can significantly reduce the incidence of gastric mucosal damage after severe brain injury ,it should be recommended to actively use in clinics.

关 键 词：重度颅脑损伤 抑酸药物 应激性胃黏膜损伤 

分 类 号：R651.15[医药卫生—外科学]