奥美拉唑快速纠正先天性肥厚性幽门狭窄代谢性碱中毒的临床研究

The clinical study of omeprazole in rapid correction of metabolic alkalosis in congenital hypertrophicpyloric stenosis

目的探讨奥美拉唑在快速纠正先天性肥厚性幽门狭窄代谢性碱中毒中的作用。方法将本院80例诊断为先天性肥厚性幽门狭窄的患儿随机分成两组，治疗组40例，对照组40例。根据人院时pH值又分为pH〉7．5组（治疗组21例，对照组22），pH≤7．5组（治疗组19例，对照组18例）。对照组采用补充生理盐水、平衡液等纠正电解质紊乱及酸碱失衡，治疗组除采用上述治疗外加用奥美拉唑0．7mg·kg^-1·d^-1静脉滴注，每日1次。人院后每12h行动脉血气分析，数据通过SPSS13．0软件包进行统计学处理。结果pH〉7．5组：入院后12h治疗组有8例（8／21，38．1％）pH值恢复正常，对照组仅2例（2／22，9．1％）恢复正常（P〈0．05）。入院后24h，治疗组有18例（18／21，85．7％）pH值恢复正常，而对照组仅5例（5／22，22．7％）pH值恢复正常，两组比较差异有统计学意义（P〈0．01）。pH≤7．5组：人院后12h治疗组有15例（15／19，78．9％）pH值恢复正常，对照组有9例（9／18，50．0％）恢复正常。人院后24h治疗组有15例（15／19，78．9％）pH值恢复正常，对照组有13例（13／18，72．2％）恢复正常。入院后36h治疗组pH值已全部恢复正常，对照组有16例（16／18，88．8％）恢复正常。两组比较，差异无统计学意义（P〉0．05）。结论奥美拉唑能快速纠正先天性肥厚性幽门狭窄代谢性碱中毒，对纠正中重度代谢性碱中毒尤为显著。

Objetive To explore the function of omeprazole in rapid correction of metabolic alkalosis in congenital hypertrophic pyloric stenosis（CHPS）. Methods 80 infants with CHPS were randomly divided into two groups, treatment group 40 cases, control group 40 cases. According to the pH on admission ,those patients were divided into pH 〉 7.5 group （treatment group 21 cases, control group 22 cases）, pH ≤7.5 group （treatment groupl9 cases,control groupl8 cases ）. The control group was given conventional normal saline,equilibrium liquid to correct electrolyte and acid-base balance disorders ,the treatment group in addition to routine therapy was given omeprazole 0.7 mg/ （ kg. d） qd intravenous injection. The arterial blood gas analysis were detected in every 12 h after admission,The SPSS13.0 software of statistics analyzed the primary data. Results pH 〉 7.5 group： 12 h after admission treatment group with 8 cases （8/21,38.1% ） pH returned to normal, while control group only with 2 cases （ 2/22,9.1% ）, （ P 〈 0.05 ）. 24 h after admission, the treatment group had 18 cases （ 18/21,85.7% ） pH returned to normal,while control group only 5 cases （5/22,22.7%） ,no significant differences in the two groups to compare（P 〈0.01 ）. phi〈7.5 group：There were 15 cases （ 15/19,78.9% ） pH returned to normal on 12 h after admission in treatment group, the control group were 9 cases （9/18,50. 0% ）. and on 24 h after admission , treatment group were 15 cases （ 15/19,78.9% ） pH returned to normal, the control group were 13 cases （ 13/18,72.2% ）. on 36 h after admission, all the pH of the treatment group had returned to normal,the control group were 16 cases （ 16/18,88.8% ）. and the two groups had no significant difference（ P 〉 0.05 ）. Conclusion Intravenous omeprazole administration can rapidly normalize severe meta-bolic alkalosis in CHPS patients, particularly for moderately severe metabolic alkalosis. As a result, pyloromyoto- my can be performed sooner reducing both hospital stay and costs.