探讨颅脑损伤并发上消化道出血机制及防治原则

Pathogenic mechanisms and prevention on upper gastrointestinal bleeding after craniocerebral injury

目的 探讨颅脑损伤并发上消化道出血机制及防治.方法 回顾性分析本科自1995年以来诊治颅脑损伤477例,其中并发上消化道出血54例.结果 颅脑损伤越严重,GCS评分越低,上消化道出血发生率越高.脑干及下丘脑部损伤后上消化道出血发生率高.重型颅脑损伤患者预防用药后上消化道出血发生率低于未用药者.结论 出血与GCS评分、受伤程度有密切关系,同时,早期预防用药能降低其发生率,提高治愈率.

Objective To study pathogemc mechamsms and prevention on upper gastrointestinal bleeding （UGB） after cramocerebral injury （CI）, Methods 477 patients with CI admitted to our department from 1995 were retrospectively analyzed, and 54 patients followed by UGB, Results The incidence of UGB increased with the decrease of GCS and the aggravation of severity of C1. Patients with injuries of the brain stem or hypothalamus had significan higher incidence of UGB than others. During severe craniocerebral injury, the incidence of UGB was significantly cecreased in the patients with early drug therapy for prevention. Conclusion The incidence of UGB has close relation to C - S and severity types of head injuries, it is suggested that the early drug therapy for prevention can decrease the incidence of UGB and increase the cure rate.