重症患者早期监测胃液对预防应激性溃疡用药时机的对比观察

目的对比观察以胃酸pH值为指标应用抑酸药对重症患者应激性溃疡的预防作用。方法对ICU重症患者202例随机分为A组(69例)、B组(66例)和C组(67例),入院时均留置鼻胃管,每12h抽吸1次空腹胃液,测定胃液pH值和潜血试验,观察期10d。A组当胃液pH值<4.0和B组胃液pH值<2.0时,奥美拉唑30mg,胃管内注入,2次/d,使其胃液pH>5.0时为止。结果A组和B组预防应用抑酸剂后使胃液pH均值较C组显著提高(P<0.01)。3组应激性溃疡发生例数分别为18例,28例和33例。A组较B组抑酸预防应激性溃疡有较好疗效(P<0.05),B组与C组差异无显著性。上消化道出血发生率A组(8.70%)和B组(9.03%)均较C组(22.39%)减低(P<0.05)。结论监测重症患者胃液pH<4.0时,是开始应用抑酸药物预防应激性溃疡提高疗效的优选指标。

Effect on Srtess Ulcer in the Critically Prophylactic Bykeeping Gastric Canal to Monitring the Juices Early

Objective To obeserve the precaution of stress ulser in the critically ill with antacials early by gastric acid value target.Methods 220 serious illness in ICU were divided into group A(69 cases).group B(66 cases) and group C(67 cases) randomly,retanining gastric canal adimission,to sucking the iuices per 12 hours.When the juices PH value was less than 4 in the group A and less than 2 in the group B,omeprezole 30 mg was iminited by gastric canal twice a day,until the juices PH value was larger than 5.Results The juices PH value in A and B groups was more rised than that of group C after antacids (P<0.01).Hepping stress ulser in A、B and C groups was 18.28 and 33 cases respectively,it was better in group A than group B that preventing tress ulser with antacids,and no significance in group B than group C.Incidence of hemorrhage of upper digestive tract was more depress in group A and B than group C.Conclusion When monitoring juices PH value in critically ill was less than 4,It is hetter target that beginning apply antancids to precente stress ulser for rise result.