危重患者使用奥美拉唑的合理疗程研究

Rational Treatment Course of Omeprazole for Critical Patients

目的:研究危重患者使用质子泵抑制药奥美拉唑的合理疗程,提高患者预后,减少重症监护室(ICU)住院时间及治疗费用。方法:180例APACHEⅡ>10分且机械通气>48 h的ICU危重患者随机分为3组,分别使用奥美拉唑1 d、3 d、5 d等不同疗程。比较3组患者应激性溃疡和消化道出血发生率、呼吸机相关性肺炎(VAP)发生率,以及三组ICU住院时间及治疗费用。结果:3 d、5 d组应激性溃疡和消化道出血发生率均明显低于1 d组(P<0.05);VAP发生率3 d组最低,与1 d、5 d组比较,差异均有统计学意义(P<0.05);三组间ICU住院时间及治疗费用比较均差异明显(P<0.05),3 d组ICU住院时间最短,治疗费用最少。结论:奥美拉唑3d疗程较合理,不仅可预防危重患者发生应激性溃疡和消化道出血,且可降低VAP发生率低,ICU住院时间短,治疗费用少。

Objective： To study the rational treatment course of proton pump inhibitor omeprazole for critical patients in order to improve the prognosis and reduce the hospital stay and treatment expense. Methods：Totally 180 critical patients with APACHEⅡ＆gt;10 and mechanical ventilation ＆gt;48 hours in ICU were selected and randomly divided into 3 groups treated by omeprazole for 1 day, 3 days and 5 days , respectively. The incidence rate of stress ulcer, gastrointestinal hemorrhage and ventilator-associated pneumonia （ VAP） in the three groups was studied, and the ICU stay and expense were also investigated. Results：The incidence rate of stress ul-cer and gastrointestinal hemorrhage in the group with treatment course of 3 days and 5 days were significantly lower than those in the group with 1 day treatment（P〈0. 05）. The incidence rate of VAP with 3-days treatment was the lowest, compared with 1 day and 5 days treatment, the different was satatistically significant（P〈0. 05）. The ICU hospitalization time and treatment expense were also significantly different among the three groups, and that in 3-days, group was the lowest（P〈0. 05）. Conclusion：The 3-day treatment is the most reasonable, which can not only prevent stress ulcer and gastrointestinal bleeding in critical patients, but also reduce the in-cidence of VAP with lowered hospital stay and expense.