酸分泌抑制剂对颅脑损伤后应激性溃疡的预防作用

Efficacy of defending use of the inhibitors of gastric acid secretion in the stress ulcer after craniocerebral injuries

目的 :观察酸分泌抑制剂预防颅脑损伤后应激性溃疡的效果。方法 :将 112例颅脑损伤患者随机分成预防用药组(n =5 7)和对照组 (n =5 5 ) ;预防用药组根据使用药物不同再分成A组 (奥美拉唑 4 0mg·d-1)和B组 (西咪替丁 2 0～ 30mg·kg-1·d-1)。以呕血、胃液或粪隐血试验和空腹胃液的pH值等为观察指标。结果 :预防用药组应激性溃疡发生率 (17 5 4 % )和死亡率 (5 2 6 % ) ,与对照组 (4 5 .4 5 % ,18 18% )比较均有显著性降低 (P <0 0 1,P <0 0 5 ) ;A组应激性溃疡发生率 (6 90 % )与B组 (2 8 5 7% )比较明显减少 (P <0 0 5 ) ,但 2组死亡率比较无显著性差异 (P >0 0 5 )。结论 :颅脑损伤后尽早使用酸分泌抑制剂能显著降低应激性溃疡的发生率和死亡率 ;

AIM:To observe the efficacy of defending use of the inhibitor of gastric acid secretion in stress ulcer after craniocerebral injuries. METHODS: The 112 patients were randomly divided into 2 groups, defending use group (n=57)and control group (n= 55). The 57 patients in the defending use group were randomly divided into group A (omeprazole 40 mg·d -1) and group B (cimetidine 20-30 mg·kg -1·d -1). RESULTS:The frequencies of stress ulcer (17.54%) and the mortalities (5.26%) in the defending use group were lower than those in the control group (45.45%,18.18%;P<0.01,P<0.05). The frequencies of stress ulcer in the group A(6.90%) decreased more than those in the group B(28.57% , P<0.05),but there was no significant difference for the mortalities between the group A and the group B. CONCLUSION:The defending use of the inhibitors of gastric acid secretion in early stage can reduce remarkably the frequencies of stress ulcer and mortalities after craniocerebral injuries and promote curative effects. Omeprazole is more effective than cimetidine in the defending use.