以胃液pH值为导向的颅脑损伤应激相关性黏膜病变预防策略及其对相关临床事件的影响  

Prevention strategy of craniocerebral injury stress-related mucosal disease oriented by gastric fluid pH value and its influence on relevant clinical events

作　　者：江皓波[1] 刘海木 李翠玉[1] JIANG Haobo;LIU Haimu;LI Cuiyu(Department of Critical Care Medicine,Foshan Hospital of Traditional Chinese Medicine,Foshan 528000,Guangdong,China)

机构地区：[1]佛山市中医院重症医学科,广东省佛山市528000

出　　处：《广西医学》2023年第13期1547-1550,共4页Guangxi Medical Journal

基　　金：广东省佛山市科技创新项目自筹经费类科技计划项目(2020001005652)。

摘　　要：目的探讨以胃液pH值为导向的颅脑损伤应激相关性黏膜病变(SRMD)预防策略及其对相关临床事件的影响。方法将72例颅脑损伤患者随机分为对照组35例与观察组37例。给予对照组患者常规静脉注射质子泵抑制剂(PPI)预防SRMD,给予观察组患者以胃液pH值为导向的预防策略。比较两组患者住院期间SRMD、医院获得性肺炎(HAP)、艰难梭菌感染(CDI)、呼吸衰竭、休克、肾功能受损及死亡的发生率。结果两组患者的SRMD、肾功能受损及死亡发生率比较,差异均无统计学意义(均P>0.05)。观察组HAP、CDI、呼吸衰竭、休克的发生率均低于对照组(均P<0.05)。结论相比于常规的PPI预防策略,采用以胃液pH值为导向的预防策略,可在保证SRMD预防效果的同时,降低颅脑损伤患者的HAP、CDI、呼吸衰竭、休克发生率,安全性较高。Objective To explore the prevention strategy of craniocerebral injury stress-related mucosal disease(SRMD)oriented by gastric fluid pH value and its influence on relevant clinical events.Methods A total of 72 patients with craniocerebral injury were randomly assigned to control group(35 cases)or observation group(37 cases).The control group received routine intravenous injection of proton-pump inhibitor(PPI)to prevent SRMD,and the observation group employed prevention strategy oriented by gastric fluid pH value.The incidence rates of SRMD during hospitalization,hospital-acquired pneumonia(HAP),Clostridium difficile infection(CDI),respiratory failure,shock,impaired renal function,and mortality were compared between patients of the two groups.Results There was no statistically significant difference in the incidence rates of SRMD,impaired renal function,and mortality between patients of the two groups(all P>0.05).The observation group exhibited lower incidence rates of HAP,CDI,respiratory failure,shock as compared with the control group(all P<0.05).Conclusion Compared with routine PPI prevention strategy,employing prevention strategy oriented by gastric fluid pH value can decrease the incidence rates of HAP,CDI,respiratory failure,and shock in patients with craniocerebral injury while ensuring the prevention effect of SRMD,exerting a relatively high safety.

关 键 词：应激相关性黏膜病变 颅脑损伤 胃液 PH值 预防效果 

分 类 号：R57[医药卫生—消化系统]