抑酸剂对脑手术应激病人的胃酸影响

Effects of Antacid on Gastric Acid Secretion in Patients of Brain Operation

目的：探讨抑酸剂质子泵抑制剂和Ｈ２受体拮抗剂对颅脑围手术期患者胃酸分泌的影响。方法：（１）３０例患者随机分组：Ｈ２受体拮抗剂泰胃美组、质子泵抑制剂洛赛克组和对照组；（２）所有病例均于手术前４小时监测胃内ｐＨ至７２小时；（３）分析颅脑手术患者术前、术中、术后胃内平均ｐＨ及ｐＨ＜４时间百分率＿结果：颅脑手术患者术中胃内ｐＨ显著高于术前（Ｐ＜０．０５），术后胃内ｐＨ显昏低于术前（Ｐ＜０．０５）巳受体拮抗剂较对照组，能显著升高术后胃内ｐＨ（Ｐ＜０．０５）质子泵抑制剂和对照组比较，升高术后胃内ｐＨ更显著（Ｐ ＜０．０１）结论：颅脑手术术后胃酸呈高分泌状态．

Purpuse: To evaluate the efficacy of H2-blocker, Proton pump inhibitor on the gastric acid secretion during perioperative period in patients undergoing brain operation. Methods: Thirty patients were divided randomizely into three groups: H2 -blocker group wlth tagamet, proton pump inhibitor group with losec and control group with routine therapy. Intragastric pH monitoring were conducted 4 hours before op- eration and continued for 72 hours in all of these patients. The changes of intragastric mean pH and percant of time < 4 before, during and after operation were analyzised and the efficacy of proton pump inhibitor and H2--blocker on gastric pH were evaluated. Results: In brain operation patients the intragastric pH was sig- nificantly increased during the operation (P.< 0. 05 ), while it was significantly decreased after operation comparing with those of before operation ( P <0.05) H2 -blocker could block the decrease of the intragastric PF I comparing with those of control group ( P <0.05) proton pump inhibitor could raise the intragastric pH comparing with those of control ( P <0. 01) . Conclusion: There was hypersecretion of the gastric acid in the brain operation patients. H,-blocker and proton rump inhibitor could inhibit the gastric acid secretion and might prevent upper gastrointestinal bleeding in brain operation patients.