胃黏膜pH值监测对多器官功能障碍的早期预警价值

目的探讨胃黏膜pH值(pHi)监测在早期预测危重患者发生多器官功能障碍综合征中的价值。方法测量20例危重患者入院和入院24 h的胃黏膜pH值,并根据多器官功能障碍综合征诊断标准1]将患者分为多器官功能障碍组(A组)和非多器官功能障碍组(B组),其中A组又分为2个器官功能障碍组(A1组)和>2个器官功能障碍组(A2组),分别比较A和B组以及A1和A2组的胃黏膜pH值。结果 20例危重患者入住ICU 24 h后发生多器官功能障碍者9例,2个器官功能障碍者4例,>2个器官功能障碍者5例。A组的胃黏膜pH值低于B组(P<0.01),A2组的胃黏膜pH值低于A1组(P<0.01)。结论胃黏膜pH值水平与危重患者发生多器官功能障碍有相关性,是早期预测多器官功能障碍的重要监测指标之一。

Early warning value of pH value of gastric mucosa on multiple organ dysfunction

Objective To investigate the value of gastric intramucosal pH（pHi） in the early prediction of critically ill patients with multiple organ dysfunction syndrome. Methods Twenty critically ill patients＇s gastric intramucosal pH immediately and 24 hours later were measured,then patients were divided into multiple organ dysfunction group（group A） and non multiple organ dysfunction group（group B） according to the diagnostic standard of multiple organ dysfunction syndrome.Group A was subdivided into 2 organ dysfunction group（A1） and more than 2 organ dysfunction group（A2）.Gastric intramucosal pH of group A and group B were firstly,then A1 with A2 group. Results There were 9 cases with multiple organ dysfunction syndrome.Four cases with 2 organs dysfunction,5 cases with more than 2 organs dysfunction.Gastric intramucosal pH in group A wab lower than that in group B（P0.01）,gastric intramucosal pH in group A2 was lower than that in group A1（P0.01）. Conclusion The level of gastric intramucosal pH was revelant to multiple organ dysfunction syndrome.It is one of the important indicators in the early prediction of critically ill patients with multiple organ dysfunction syndrome.