高血压性脑出血患者术后胃粘膜内pH值的监测及意义

Significance of changes of intramucosal pH after hypertensive cerebral hemorrhage

目的研究高血压性脑出血患者术后胃粘膜内pH值(pHi)的变化及其与应激性溃疡出血的关系。方法利用胃张力管检测78例高血压性脑出血患者术后不同时间pHi,同时测定不同时段胃液pHi值,比较发生与未发生应激性溃疡出血患者的差异。结果78例患者中21例发生了应激性溃疡出血,其入院时的pHi均值与未出血组无显著差异;入院后第24 h、第3、57、d 2组间均有显著差异;出血组与未出血组第1、2 d胃液pH值无显著差异,以后每天差异有显著性。结论监测pHi对高血压性脑出血患者术后应激性溃疡出血的发生具有预警作用。

Objective To detect the intramucosal pH（pHi） changes after hypertensive cerebral hemorrhage and its correlation to stress ulcer bleeding. Methods 78 cases of hypertensive cerebral hemorrhage were enrolled and their pHi were determined at different time points with tonometry. The pH of gastric juice was monitored for 7 days. Results 21 cases in bleeding group developed stress ulcer bleeding. On admission, the pHi was not significantly different in the non-bleeding group, but the differences between the two groups at 24 hours, the 3^rd, 5^th, 7^th day after admission were significant, pHi in the bleeding group was statistically lower than non-bleeding group. The pH values of gastric juice were not significantly different between the two groups on the first and the second day and the differences between the two groups on 3^rd, 4^th Up to the 7^th day after admission were significant. Conclusions In bleeding group, there is significantly lower pHi than the nonbleeding group during the treating periods, pHi has predictive value of bleeding from stress ulcer after hypertensive cerebral hemorrhage.