硝苯地平与大黄粉鼻饲对重症脑出血患者预防应激性溃疡的疗效观察

Preventive effect of nifedipine and rhubarb powder on stress ulcer caused by severe cerebral hemorrhage

目的 :探讨硝苯地平与大黄粉鼻饲预防重症脑出血患者并发应激性溃疡的疗效。方法 :75例患者随机分为治疗组 40例和对照组 35例。2组均给予 2 0 %甘露醇及速尿脱水 ,静滴甲基氢化泼尼松以治疗脑水肿等常规治疗 ,在此基础上治疗组加用硝苯地平 10 mg,大黄粉 10 g鼻饲 ,每日 3次 ;对照组加用法莫替丁 2 0 m g鼻饲 ,每日 2次。 2组均治疗 2周后观察疗效。结果 :治疗组并发应激性溃疡 5例 (12 .5 % ) ,死亡 6例 (15 .0 % ) ,应激性溃疡发生率和病死率均明显低于对照组〔分别为 15例 (42 .9% )和 13例 (37.1% ) ,P<0 .0 1和 P<0 .0 5〕。结论 :硝苯地平与大黄粉鼻饲对重症脑出血患者并发应激性溃疡有较好的预防作用。

Objective:To explore the preventive effect of nifedipine and rhubarb powder on stress ulcer caused by severe cerebral hemorrhage (SCH).Methods:75 patients with SCH were randomly divided into two groups.On the base of treated with 20% mannitol,furosemide and solumedrol,treatment group of 40 patients was treated with nifedipine 10 mg and rhubarb powder 10 g three times per day,control group of 35 patients were treated with famotidine 20 mg two times per day.The clinically curative effect was observed after two weeks.Results:The incidence of stress ulcer 〔12 5%(5/40)〕 and mortality 〔15 0%(6/40)〕 in treatment group were obviously lower than those in control group 〔42 9%(15/35) and 37 1%(13/35) respectively, P <0 01 and P <0 05 〕.Conclusions:Nifedipine and rhubarb powder have obvious preventive effect on stress ulcer caused by SCH.