重症脑卒中患者胃肠道衰竭的预防性治疗对预后的影响

Effects of Prophylactic Treatment of Gastrointestinal Tract Failure on Prognosis of Patients with Critical Cerebral Apoplexy

目的:探讨重症脑卒中患者胃肠道衰竭的发生率及预防性予以胃肠道保护治疗对预后的影响。方法:重症脑卒中患者328例随机分为2组;预防组154例,预防性予以抑酸、保护胃粘膜和胃肠动力药物治疗;对照组174例,在出现胃肠道衰竭时予以同样药物治疗。观察2组患者胃肠道衰竭、多脏器功能衰竭(MODS)的发生率和预后情况。结果:预防组患者胃肠道衰竭86例(55.84%),MODS 64例(41.56%),死亡19例(12.34%);对照组患者胃肠道衰竭112例(64.37%),MODS 95例(54.60%),死亡44例(25.29%)。2组胃肠道衰竭发生率无差别,但预防组MODS发生率和死亡率低于对照组。结论:重症脑卒中患者发生胃肠道衰竭机率高(60.37%),预防性治疗不能降低胃肠道衰竭的发生率,但可以降低MODS的发生率和死亡率。

Objective： To explore the incidence rate of gastrointestinal tract failure and the effects of prophylactic treatment of gastrointestinal tract failure on prognosis of critical cerebral apoplexy patients.Methods： 238 cases of critical cerebral apoplexy patients were randomly divided into treatment group（n=154） and control group（n=174）.The patients in the treatment group were treated with anti-gastric acid,gastric mucosa protection and stomach intestine dynamic drugs prophylacticly while patients in control group were not treated with the same drugs until they were digested gastrointestinal tract failure.The incidence rate of gastrointestinal tract failure,mutiple organs disfunction syndrome（MODS） and prognosis of the two groups were analyzed.Results： In treatment group the incident rate of gastrointestinal tract failure,MODS and mortality was 86（55.84%）,64（41.56%） and 19（12.34%） respectively and in control group was 112（64.37%）,95（54.60%） and 44（25.29%） respectively.There was no difference between the two groups in cause of incidence rate of gastrointestinal tract failure but the incidence rate of MODS and mortality of treatment group were less than that of the control group.Conclusion： The incidence rate（60.37%） of gastrointestinal tract failure was considerably high in critacal cerebral apoplexy patients.Prophylactic treatment of gastrointestinal tract failure could not reduce the incidence rate of gastrointestinal tract failure but the incident rate of MODS and mortality.