重度颅脑损伤并发应激性溃疡482例临床分析

Pathogenesis and therapy of severe craniocerebral injury patients complicated with stress ulcer bleeding in 482 cases

目的通过对482例重度颅脑损伤并发应激性溃疡患者的治疗方法进行回顾性分析，探讨重度颅脑损伤并发应激性溃疡出血的机制及治疗方法。方法积极治疗原发病及并发症，加强对症支持治疗，早期留置胃管、鼻饲，静脉应用质子泵抑制剂，局部应用胃黏膜保护剂。结果388例临床治愈，94例死亡，病死率约19．5％。结论重度颅脑损伤并发应激性溃疡出血，病死率高，应早预防、早发现、早治疗。

Objective To explore the pathogenesis and therapy of 482 cases of severe craniocerebral injury patient s complicated with stress ulcer bleeding through analysis retrospectively. Methods The treatment included the primary disease and complications actively, enhancing the supportive t reatment,indwelling feeding tube and nasal feeding early, applying the proton pump inhibitor by int ravenous injection, and applying the gastricmucosal protectant locally. Results 388 cases were cured,94 cases were died,the death rate was about 19.5%. Conclusion Severe craniocerebral injury patients complicated with stress ulcer bleeding had high death rate, and should be early prevention, discovery and treatment.