弱碱性流质饮食联合多潘立酮预防脑卒中及重型颅脑损伤患者并发应激性溃疡出血的应用价值  

Clinical application value of alkalescent liquid diet combined with Domperidone in the prevention of stress ulcer hemorrhage in patients with stroke and severe craniocerebral injury

作　　者：黄谷[1] 方耿娜[1] 魏二佳[1] 洪映标[1] 黄正华[1] 

机构地区：[1]广东省揭阳市人民医院神经外科,广东揭阳522000

出　　处：《临床和实验医学杂志》2017年第2期146-148,共3页Journal of Clinical and Experimental Medicine

基　　金：广东省揭阳市科技局项目(编号:2015B01008)

摘　　要：目的探讨弱碱性流质饮食联合多潘立酮预防脑卒中及重型颅脑损伤患者并发应激性溃疡出血的应用价值。方法选取2014年1月至2016年6月脑卒中及重型颅脑损伤患者142例作为研究对象。将患者按照监测的胃液pH值进行分组,pH<4.0者随机分为A、B两组各51例,pH值≥4.0者为C组(40例)。A组患者进食豆浆、米汤等弱碱性流质饮食饮食并加用多潘立酮10 mg鼻饲干预;B组静脉应用奥美拉唑60 mg静滴,每日2次;C组不用任何药物干预,分别监测14天。对比三组间的胃酸强度、应激性溃疡出血的发生率及不良反应的发生情况。结果 A组患者平均胃液pH值与夜间平均胃液pH值均显著高于B组患者(P<0.05)。A组应激性溃疡发生率5.9%(3/51),B组应激性溃疡发生率25.5%(13/51),A组应激性溃疡发生率显著低于B组(P<0.05),同时A组的胃液潜血率与大便潜血率亦显著低于B组(P<0.05);C组未见应激性溃疡出血发生,且C组的胃液潜血率与大便潜血率低于其他两组(P<0.05)。A组各项不良反应的发生率均明显低于B组(P<0.05)。结论对脑卒中或重型颅脑损伤患者给予弱碱性流质饮食联合多潘立酮干预,可有效中和胃酸,预防应激性溃疡出血的发生,同时具有较高的安全性。Objective To study the clinical application value of alkalescent liquid diet combined with Domperidone in the prevention of stress ulcer hemorrhage in patients with stroke and severe craniocerebral injury.Methods 142 patients with stroke and severe craniocerebral injury treated from January 2014 to June 2016 were selected.The subjects were divided into group A（51 cases,pH〈4.0）,groupB（51 cases,pH〈4.0） and group C（40 cases,pH≥4.0） according to pH value.Group A took the alkalescent liquid diet of soybean milk and rice water and nasal feeding of Domperidone（10 mg）.Group B took the venous injection of Omeprazole（60 mg） for two times a day.Group C did not take the drugs.After 14 d of treatment,the gastric acidity,incidence rate of stress ulcer hemorrhage and adverse reactions were observed.Results The average pH value and average pH value at night for group A was higher than that in group B（P〈 0.05）.The incidence rate of stress ulcer hemorrhage in group A（3 cases） was lower than that in group B（13 cases）（P 〈0.05）.In the gastric fluid and stool,the incidence rate of occult blood in group A was lower than that in group B（P〈 0.05）;group C had no case of stress ulcer hemorrhage.In the gastric fluid and stool,the incidence rate of occult blood for group C was lower than those of the other groups（P〈 0.05）.The adverse event rate for group A was lower than that in group B（P 〈0.05）.Conclusion For patients with stroke and severe craniocerebral injury,the alkalescent liquid diet and Domperidone can efficiently neutralize the gastric acid,reduce the incidence rate of stress ulcer hemorrhage and improve the clinical safety.

关 键 词：脑卒中 重型颅脑损伤 应激性溃疡出血 弱碱性流质饮食 多潘立酮 

分 类 号：R651.15[医药卫生—外科学]