兰索拉唑联合铝镁加在重型颅脑损伤并发应激性溃疡中的应用研究

Application of Lansoprazole Plus Almagate in the Treatment of Severe Craniocerebral Injury Complicated with Stress Ulcers

目的探讨兰索拉唑联合铝镁加治疗重型颅脑损伤并发应激性溃疡(SU)的临床疗效,以及其对患者胃肠激素、胃液pH值及血清白细胞介素⁃2(IL⁃2)水平的影响。方法选取2019年4月至2020年3月开封市中心医院收治的68例重型颅脑损伤并发SU患者作为研究对象,并按照随机数表法将其随机分为观察组(32例)和对照组(36例),观察组患者采用兰索拉唑联合铝镁加治疗,对照组患者单纯采用铝镁加治疗,对比两组患者胃肠激素、胃液pH值、血清IL⁃2水平变化情况以及临床疗效和不良反应发生情况。结果治疗3、7 d时,观察组患者胃泌素(GAS)、胃动素(MTL)均明显低于对照组(治疗3 d:t=3.767、5.170,P均<0.001;治疗7 d:t=12.980、8.506,P均<0.001);血管活性肠肽(VIP)、胃液pH值及血清IL⁃2水平均明显高于对照组(治疗3 d:t=2.236、2.484、11.050,P=0.028、P=0.015、P<0.001;治疗7 d:t=7.827、2.124、3.926,P<0.001、P=0.037、P<0.001)。观察组患者临床疗效明显优于对照组(Z=-2.085,P=0.037);治疗过程中,两组患者均无不良反应发生。结论给予重型颅脑损伤并发SU患者兰索拉唑联合铝镁加治疗,可有效改善患者胃肠激素水平,抑制胃酸过度分泌,提高血清IL⁃2水平,促进胃肠功能恢复,疗效显著,且安全性较高。

Objective To investigate the clinical efficacy of Lansoprazole plus Almagate in the treatment of severe craniocerebral injury complicated with stress ulcer(SU),and its impacts on levels of gastrointestinal hormone,gastric fluid pH,and interleukin⁃2(IL⁃2)in such patients.Methods 68 patients with severe craniocerebral injury complicated with SU,admitted to Kaifeng Central Hospital between April 2019 and March 2020,were enrolled and divided,using random number table,into study group(n=32)and control group(n=36).Patients in study group were treated with Lansoprazole plus Almagate,whereas patients in control group were given only Almagate.The changes of gastrointestinal hormone,gastric fluid pH and IL⁃2,clinical efficacy and occurrence of adverse reactions were compared between the two groups.Results After 3 and 7 days of treatment,the levels of gastrin(GAS)and motilin(MTL)of patients in study group were all signifi⁃cantly lower than control group(day 3 of treatment:t=3.767 and 5.170,both P<0.001;day 7 of treatment:t=12.980 and 8.506,both P<0.001);the levels of vasoactive intestinal peptide(VIP),gastric fluid pH and IL⁃2 of patients in study group were all markedly higher than control group(day 3 of treatment:t=2.236,2.484,11.050,P=0.028,P=0.015,P<0.001;day 7 of treatment:t=7.827,2.124,3.926,P<0.001,P=0.037,P<0.001).The clinical efficacy in study group was obviously superior to that in control group(Z=-2.085,P=0.037).During the course of treatment,no adverse reactions were observed in both groups.Conclusion The combined application of Lansoprazole and Almagate in the treatment of severe craniocerebral injury complicated with SU can effectively improve gastrointestinal hormone level and IL⁃2 level of patients,inhibit excessive secretion of gastric fluid,and promote the restoration of gastrointestinal functions,and the clinical efficacy was significant,with high safety.