奥美拉唑在上腹部术中对胃pH的影响及临床意义

目的　探讨奥美拉唑对上腹部术中胃食管反流的预防效果。方法择期胆囊手术１５８例，随机分成Ａ组：于术前晚和术晨各口服奥美拉唑４０９ｍｇ；Ｂ组：加服西沙必利１０ｍｇ；Ｃ组：为对照组。用胃食管ＰＨ仪，分别测定术前胃内ｐＨ和连续监测术中食管下端ｐＨ值。结果 Ａ、Ｂ二组术前服药后胃内ｐＨ均值分别为 ５．１２±１．１３和５．４４±１．０２，术中食管下端ｐＨ无一人＜４．０，组间无明显差异，而Ｃ组术前胃内ｐＨ均值为１．９８±０．８２（Ｐ＜０．０１），术中食管下端ＰＨ＜４．０发生率为６３％（３３／５２）。结论术前口服奥美拉唑可明显提高胃内ｐＨ值，能起到预防或减少胃食管反流的效果。

Clinical Significance and Effect of Omeprazole on Gastric pH in Epigastric Operation

Objective: To investigate the efficiency of omeprazole in preventing gastroesophageal reflux in epigastric operation. Methods 158 patients subject to selective cholecystectomy were randomly divided into three groups, with group A given omepraaole 40mg orally on the previous night and the morning of the day of operation, group B added cisapride 10mg, group C as a control group with neither of the above mentioned drugs. Using gastroesophageal pH electrode, gastric pH was measured before the operation and the lower esophageal pH was continuously monitored during the operation. Results Gastric pH of group A and B were 5. 12 ± 1. 13 and 5. 44 ± 1. 02 before operation respectively and no patient had esophageal pH lower than 4.0 during operation. There was no significant difference found between the two groups.Compared with that of group A and B,gastric pH in group C was 1.98±0. 82 (p<0.01) before the operation. However, the lower esophageal pH lower than 4.0 were 33 out of 52 (63% ) during operation. Conlusion Omeprazole taken before operation could obviously increase gastric pH and prevent gastroesophageal reflux.