神经外科重症病人早期胃肠道营养预防消化道出血探讨

Effect of Early Gastrointestinal Nutrition on Prophylaxis of Upper Gastrointestinal Hemorrhage in Severe Neurosurgical Patients of ICU of Neurosurgery Department

目的降低神经外科重症病人上消化道出血发生率。方法将122例病人随机分为A、B两组。A组56例常规防治上消化道出血,B组66例在此基础上(不用碱性药中和胃酸)于入院后或手术后12 h予鼻饲流质。结果B组病人上消化道出血及首次出血发生率显著低于A组(均P<0.05);病人胃液pH值<4.0 A组为76.8％,B组为16.7％。结论早期胃肠道营养对神经外科重症病人上消化道出血的发生有较好的预防作用。

Objective To explore the effect of early gastrointestinal nutrition on the prophylaxis of upper gastrointesti-nal hemorrhage in critical patients of ICU of Neurosurgery Department. Method One hundred and twenty-two pa-tients were randomly divided into two groups. fifty-six patients treated routinely (group A) and 66 patients given fluid diet(without alkaline agents used to neutralize gastric acid) by nasal feeding 12 hours after the operation (group B). The occult bleeding in the gastric juice and stool was examined on daily basis. Results The incidence of the gastrointestinal bleeding and the first bleeding in group A was significantly lower than that in group A (P<0. 05 for both). In group A, the pH of gastric fluid of 76. 8% of the patients was lower than 4. 0 while in group B, only 16. 7% had the pH lower than 4. 0. Conclusion The early gastrointestinal nutrition has prophylactic effect on upper gastrointestinal hemorrhage in neurosugical patients in critical condition.