摘要
目的探讨奥美拉唑治疗急性胃肠功能损伤(AGI)的临床疗效及其与呼吸机相关性肺炎(VAP的关系。方法选取梧州市红十字会医院ICU 2016年3月-2018年8月收治的AGI患者183例,根据入住ICU 24 h内的实验室检查结果,即淀粉酶、脂肪酶、胃蛋白酶原I(PGI)分为正常组95例和异常组88例。将正常组随机分为对照组48例和治疗组47例。将异常组随机分为对照组44例和治疗组44例。正常组和异常组患者中对照组给予常规治疗,治疗组在对照组基础上给予奥美拉唑治疗。比较正常组和异常组患者中治疗组与对照组的胃肠道症状缓解率、病死率、VAP发生率。结果正常组中两组患者胃肠道症状缓解率、病死率比较,差异无统计学意义(P>0.05);治疗组VAP发生率高于对照组(P<0.05)。异常组中治疗组胃肠道症状缓解率高于对照组(P<0.05);两组患者病死率、VAP发生率比较,差异无统计学意义(P>0.05)。结论实验室指标正常的AGI患者不宜使用奥美拉唑,易增加VAP的发生风险;但实验室指标异常的患者使用奥美拉唑可缓解胃肠道症状,不易增加VAP发生风险。因此AGI患者应根据实验室检查结果应用奥美拉唑。
Objective To investigate the clinical efficacy of omeprazole for AGI and its relationship with VAP.Methods A total of 183 cases of AGI patients were selected from March 2016 to August 2018 in Department of ICU,Wuzhou Red Cross Hospital,which were divided into normal group(n=95)and abnormal group(n=88)according to the laboratory examination results of amylase,lipase and PGI within 24 hours.The normal group was randomly divided into control group(n=48)and treatment group(n=47).The abnormal group was randomly divided into control group(n=44)and treatment group(n=44).The control group was given routine treatment,while the treatment group was given omeprazole treatment based on control group.The remission rate of gastrointestinal symptoms,mortality rate and VAP incidence rate were compared between control group and treatment group.Results In the normal group,there was no significant differences in the remission rate of gastrointestinal symptoms or mortality rate between the two groups(P>0.05);the treatment group of the VAP incidence rate was higher than control group(P<0.05).In the abnormal group,the treatment group of the remission rate of gastrointestinal symptoms was higher than control group(P<0.05);there was no significant differences in mortality rate or VAP incidence rate between the two groups(P>0.05).Conclusion Omeprazole is not suitable for AGI patients with normal laboratory indicators,which increases the risk of VAP.However,Omeprazole can alleviate gastrointestinal symptoms in patients with abnormal laboratory indicators without increasing the risk of VAP.Therefore,patients with AGI should use omeprazole according to the results of laboratory tests.
作者
明静
刘俊
潘子阳
黄鑫波
MING Jing;LIU Jun;PAN Zi-yang(Department of ICU,Wuzhou Red Cross Hospitaly Fuzhou 543002,China)
出处
《临床合理用药杂志》
2019年第15期16-17,20,共3页
Chinese Journal of Clinical Rational Drug Use
基金
广西壮族自治区卫生和计划生育委员会自筹经费科研课题(z2015113)
关键词
胃肠道
奥美拉唑
呼吸机相关性肺炎
Gastrointestinal tract
Omeprazole
Ventilator associated pneumonia
