甲氰咪胍对普胸术后应激性溃疡出血的预防作用

目的　探讨普胸术后应激性溃疡出血 (SUH)的有效预防措施。方法　选择具有高危因素的普胸手术病人 12 1例 ,分为两组。预防组61例 ,术前 3d和术后 7d ,应用西米替丁 (甲氰咪胍 ) 2 0 0mg加入 0 9%盐水 10ml中静推 ,2次 /d。对照组 60例 ,不用甲氰咪胍作预防。结果　预防组发生SUH 2例 (占 3 2 8%) ,对照组发生 9例 (占 15 0 0 %)。两组SUH发生率相比 ,预防组明显低于对照组 (χ2 =4 2 0 ,P <0 0 5 )。预防组SUH发生时间为 (5 77± 0 3 3 )d ,对照组发生时间为 (2 18± 1 79)d。SUH发生时间 ,预防组明显晚于对照组 (χ2 =1 79,P <0 0 5 )。结论　术前术后静脉应用甲氰咪胍能有效预防普胸术后应激性溃疡出血。

The Preventive Effect of Cimetidine on Stress Ulcer after Thoracic Operation

Objective To discuss the effectively preventive measure to stress ulcer hemorrhage (SUH) occurring after ordinary thoracic operation. Methods 121 patients with dangerous factors who would be performed ordinary thoracic operation were divided into two groups, i.e. preventive group and control group. The former group consisting of 61 patients was given 200mg of cimetidine (added to 10ml of 0.9% saline solution, i.v., b.i.d.) respectively three days before and seven days after operation. No cimetidine was administered for the prevention of SUH in the latter group that contained 60 ones.Results The two groups resulted respectively in two (3.28%) and nine (15.00%) cases of postoperative SUH. There was significant difference when compared between their incidences (χ 2=4.20,P<0.05). The SUH occurrence time of preventive group was on the (2.36±2.04) day after operation later than that of the control group which was on the (2.18±1.79) day (t=1.79, P<0.05). Conclusion To administer cimetidine before and after ordinary thoracic operation can prevent SUH effectively.