抑酸剂对脑手术应激病人的胃酸影响

目的：探讨抑酸剂质子泵抑制剂和Ｈ２受体拮抗剂对颅脑围手术期患者胃酸分泌的影响。方法：（１）３０例患者随机分组；Ｈ２受体拮抗剂泰胃美组，质子泵抑制剂洛赛克组和对照组。（２）所有病例均于手术前４小时监测胃内ｐＨ至７２小时；（３）分析颅脑手术患者术前，术中，术后胃内平均ｐＨ及ｐＨ〈４时间百分率。

Effects of Antacid on Gastric Acid Secretion in Patients of Brain Operation

Purpuse: To evaluate the efficacy of H2-blocker, Proton pump inhibitor on the gastric acid secretion during perioperative period in patients undergoing brain operation. Methods: Thirty patients were divided randomizely into three groups: H2 -blocker group wlth tagamet, proton pump inhibitor group with losec and control group with routine therapy. Intragastric pH monitoring were conducted 4 hours before op- eration and continued for 72 hours in all of these patients. The changes of intragastric mean pH and percant of time < 4 before, during and after operation were analyzised and the efficacy of proton pump inhibitor and H2--blocker on gastric pH were evaluated. Results: In brain operation patients the intragastric pH was sig- nificantly increased during the operation (P.< 0. 05 ), while it was significantly decreased after operation comparing with those of before operation ( P <0.05) H2 -blocker could block the decrease of the intragastric PF I comparing with those of control group ( P <0.05) proton pump inhibitor could raise the intragastric pH comparing with those of control ( P <0. 01) . Conclusion: There was hypersecretion of the gastric acid in the brain operation patients. H,-blocker and proton rump inhibitor could inhibit the gastric acid secretion and might prevent upper gastrointestinal bleeding in brain operation patients.