质子泵抑制剂对外科应激性溃疡及院内获得性肺炎的影响  

Effect of proton pump inhibitor on stress ulcer and hospital-acquired pneumonia

作　　者：张婷婷[1] 杨智[1] 苏伟[1] 杨自力[1] 

机构地区：[1]广州市第一人民医院重症医学科,广东广州510180

出　　处：《广州医科大学学报》2015年第1期32-35,共4页Academic Journal of Guangzhou Medical University

摘　　要：目的:探讨质子泵抑制剂对外科应激性溃疡出血(SUB)和院内获得性肺炎的影响。方法:回顾性分析2011年1-12月市第一人民医院收治的143例围手术期患者的临床资料,按照预防SUB药物的不同分为质子泵抑制剂(PPI)组(P组,106例)和H2受体拮抗剂(H2RA)组(H组,37例),P组按照PPI用药时间是否超过7 d又分为短期用药组和长期用药组,比较SUB发生率、院内获得性肺炎发生率、ICU住院时间和死亡率。结果:H组和P组患者SUB、院内获得性肺炎发生率、ICU住院时间、死亡率分别为13.5%和15.1%、13.5%和29.2%、(162.8±39.7)d和(148.3±21.7)d、21.6%和28.3%,两组比较,差异均无统计学意义(均P>0.05)。P组中长期用药组院内获得性肺炎发生率、ICU住院时间明显高于H组(P<0.05)。结论:使用质子泵抑制剂预防应激性溃疡出血的患者SUB、院内获得性肺炎发生率与使用H2受体拮抗剂者无区别,但使用质子泵抑制剂超过7 d的患者院内获得性肺炎发生率和ICU住院时间高于使用H2受体拮抗剂患者。Objective： To investigate the effect of proton pump inhibitor（ PPI） on stress ulcer bleeding（ SUB） and hospital-acquired pneumonia（ HAP）. Methods： The clinical data of 143 patients in perioperative period,who were admitted in our hospital between 2012 and 2013,were retrospectively analyzed. Using different drugs to prevent SUB,all patients were divided into PPI group（ group P,n = 106） and histamine-2 receptor antagonist（ H2RA） group（ group H,n = 37）. In group P,patients were divided into short-term medication subgroup（ subgroup S） and long-term medication subgroup（ subgroup L） according to whether the PPI medication time was over 7d. And the incidences of SUB and HAP,ICU stay,and mortality were compared.Results： The incidences of SUB and HAP,ICU stay,and mortality in group H and group P were 13. 5% vs.15. 1%,13. 5% vs. 29. 2%,162. 8 ± 39. 7 d vs. 148. 3 ± 21. 7 d,21. 6% vs. 28. 3%,respectively. And there were no statistically significant differences between the two groups（ all P〉0. 05）. And the incidence of SUB and ICU stay of subgroup L in group P was significantly higher than those in group H（ P〈0. 05）. Conclusion： There is no difference in the incidence of HAP between patients using PPI and H2 RA to prevent SUB. However,the HAP incidence and ICU stay in patients using PPI over 7d are higher than those in patients using H2 RA.

关 键 词：质子泵抑制剂 H2受体拮抗剂 应激性溃疡 院内获得性肺炎 

分 类 号：R563.1[医药卫生—呼吸系统]