神经外科ICU病人胃液pH值、胃蛋白酶、定植菌与呼吸道感染的关系研究  

Study on relationship among pH value of gastric fluid,pepsin,bacterial colonization and respiratory infections in ICU patients in Neurosurgical department

作　　者：王艳玲[1] 肖倩[1] 吴瑛[1] 孙柳[1] 王军[2] 郭桂丽[2] 鲍月红[2] 张秀云[3] 

机构地区：[1]首都医科大学护理学院 [2]首都医科大学宣武医院 [3]首都医科大学附属北京天坛医院

出　　处：《护理研究（上旬版）》2014年第7期2319-2321,共3页Chinese Nursing Researsh

基　　金：2012年度首都中医药与护理专项课题基金资助项目,编号:12ZYH10

摘　　要：[目的]了解神经外科ICU病人胃液pH值、胃蛋白酶含量及胃内细菌定植与呼吸道感染的关系,为临床给予及时的有效护理干预措施提供依据。[方法]选取北京市某三级甲等医院神经外科ICU病人进行连续3d的病情观察,并采集胃液进行pH值、胃蛋白酶含量检测及细菌培养,采集气管分泌物进行细菌培养。[结果]纳入47例病人,共收集235例次,胃液pH值为2.5~8.0(5.54±1.02);胃液pH值随ICU入住时间逐渐增加,酸度逐渐下降;胃液中胃蛋白酶含量为3.766ng/mL^84.482ng/mL,与胃液pH值呈负相关(r=-0.939,P<0.001);76.6%病人胃液中含有定植菌,85.1%病人痰液中含有定植菌,病人胃液中细菌定植菌落与呼吸道细菌菌落呈现一致的比例为57.4%。[结论]对ICU重症病人进行胃液pH值监测,可动态观察病人的病情变化,及时合理地调节胃液的酸碱度,将胃液pH值控制在适当的范围,对于病人的治疗和预后具有重要意义。Objective：To know about the relationship among pH value of gastric fluid,pepsin,bacterial colonization and respiratory infections in ICU patients in Neurosurgical department,so as to provide reference for clinical effective care interventions timely.Methods：The neurosurgical ICU patients in a three grade A hospital in Beij ing city were selected for lasting 3 days on observation on patients’condition,and the gastric juice was collected for pH value,pepsin testing and bacterial culturing,and to collect tracheal secretions for bacterial culturing.Results：47 cases of patients were included and totally 235 cases times were collected,and the pH value of gastric juice was 2.5~8.0,an average of 5.54±1.02.Gastric pH value gradually increased and the acidity decreased with the increace of length of ICU stay.The pepsin content in gastric juice was 3.766 ng/mL^84.482 ng/mL,and it was negatively correlated to gastric pH value （r= 0.939,P＆lt;0.001）.76.6% of patients had gastric colonization,85.1% of patients had sputum bacterial coloniza-tion,and their consistency ratio was 57.4%.Conclusion：Gastric pH monito-ring for ICU severe patients is helpful to observe the patient’s condition changes dynamicly,and timely and reasonablely regulate the gastric pH. Gastric pH control in the appropriate range is important for the treatment and prognosis of the patients.

关 键 词：ICU病人 胃液 pH值 胃蛋白酶 细菌定植 呼吸道感染 

分 类 号：R473.6[医药卫生—护理学]