婴幼儿体外循环心脏手术中奥美拉唑对胃肠道保护作用的临床观察

目的探讨奥美拉唑对婴幼儿体外循环（CPB）心脏手术中胃肠道的保护作用。方法45例在CPB下行先心病手术患儿,（年龄≤3岁）随机分为3组:实验A组在CPB预充液中即给予奥美拉唑10 mg,实验B组于CPB结束时给予奥美拉唑10 mg,对照组注入等量生理盐水。3组均于术前、CPB 30 m in、CPB结束后、术后4 h、24 h进行胃液常规检查,并采集血液标本,ELISA法测定血清促胃液素。结果与CPB前比较:A组胃液pH于CPB结束后有明显升高,B组胃液pH于术后4 h有明显升高,C组胃液pH变化不明显。A、B、C 3组胃液红细胞计数及血清促胃液素与本组CPB前相比均有明显上升。与对照组（C组）相比:A组胃液pH于CPB结束后各时间点较对照组明显上升,而胃液红细胞计数则有明显下降,血清促胃液素于CPB 3 m in后较对照组有明显降低。B组胃液pH于术后4、24 h较对照组有明显升高,同时间点胃液红细胞计数与促胃液素则有明显降低。结论在CPB心脏手术中预充液中即加入奥美拉唑对胃肠道有明显的保护作用。

Clinical observation on gastrointestinal protective effect of omeprazole on infants undergoing cardio-pulmonary bypass heart surgery

AIM To observe the gastrointestinal protective effect of Omeprazole on infants patients undergoing cardio-pulmonary bypass(CPB) heart surgery.METHODS Forty-five patients,who were scheduled to have CPB heart surgery were randomized equally into three groups.Before CPB,group A was treated with Omeprazole 10 mg added into priming fluid,group was B treated with Omeprazole 10 mg by intravenous dripping after CPB and control group was treated with normal saline in equal volume.pH and red blood cell of gastric juice and gastrin in blood serum were measured before CPB,30 minutes after CPB,after CPB,4 hours postoperation and 24 hours after operation.RESULTS Compared with those in control group,pH and red blood cell of gastric juice and gastrin in blood serum in group A lowered significantly during CPB,30 minutes after CPB,after CPB,4 hours postoperation and 24 hours after operation while in group B,these indexes only lowered insignificantly at 4 h and 24 hrs after CPB.Comparison between group A and group B showed that pH and red blood cell of gastric juice and gastrin in blood serum in group B were significantly higher than those in group A at 30 minutes,4 h and 24 hrs after CPB(P<0.05).CONCLUSION Omeprazole has good gastrointestinal protective effect on infants undergoing CPB cardiosurgery to some extent,which is more effective when used before CPB.