重型颅脑外伤后胃粘膜内pH值的变化及其与应激性溃疡出血的关系

Changes of intramucosal pH(pHi) after severe craniocerebral injuries and the correlation to bleeding from stress ulceration

目的 :研究重型颅脑外伤患者胃粘膜内 pH值 (pHi)的变化及其与应激性溃疡出血的关系。 方法 :1 9例重型颅脑外伤患者 ,利用胃肠张力管检测不同时间 pHi,同时测定不同时段胃液 pH值、血浆胃泌素浓度 ,比较发生与未发生应激性溃疡出血患者的差异。 结果 :1 9例患者中 5例发生了应激性溃疡出血 ,其入院时的pHi均值与未发生溃疡出血者无显著差异 ;入院后第 1 2、2 4h、第 3、5、7天两组间均有显著差异。出血组与未出血组的胃液 pH值、胃泌素水平在不同治疗阶段均无显著差异。 结论 :监测

Objective:To determine the changes of intramucosal pH(pHi) after severe craniocerebral injuries and the correlation to bleeding from stress ulceration. Methods:Nineteen cases of severe head trauma patients were enrolled, their pHi were determined at different time point with tonometry. The pH of gastric juice and plasma gastrin concentrations were monitored for 7 days. Results:Five cases(bleeding group) developed stress ulcer bleeding. On admission, the pHi were not significantly different in the non bleeding group, but the differences between two groups at 12 hours, 24 hours, the 3rd day, the 5th day, the 7th day after admission were significant, pHi in the bleeding group was statistically lower than non bleeding group. The pH values of gastric juice and the plasma gastrin concentrations were not different significantly between two groups during each therapeutic periods. Conclusion:Bleeding group had significantly lower pHi than non bleeding group during the therapeutic periods. pHi was predictive for bleeding from stress ulceration after severe craniocerebral injury.