摘要
目的 探讨严重烧伤者早期监测胃粘膜 pH值与多脏器功能不全 (MODS)的发生及死亡的关系。 方法 前瞻性地观察 2 0例烧伤面积 >5 0 %住院病人。所有病人于入院后即刻、伤后 12、2 4、36、4 8h监测动脉血气分析及胃粘膜pH值 ,于伤后 1、3、5、7、10、14d定期测定血清IL 1、IL 6、TNF α。结果 所有病人入院后即刻测定胃粘膜 pH值为 7.12± 0 .15 ,均低于正常值 ;病人胃粘膜pH值并发MODS者为 7.17± 0 .16 ,明显低于无并发MODS者 ;死亡病人胃粘膜 pH值为 7.11± 0 .13,明显低于存活者 ,并伴有血清IL 1、IL 6、TNF α含量明显增高。 结论 重症烧伤病人休克期监测胃粘膜 pH值能够及时反映组织的氧供及代谢状态 。
Objective To investigate the relationship of early monitoring gastric intramucosal pH(pHi) and predicting major morbidity and mortality after severe burn.Methods Twenty patients with more than 50 percent TBSA burn injury admitted to our hospital were entered into the study.Theasurement of gastric pHi and arterial pH(pHa) were done at immediately admission and 12,24,36,48h postburn,meanwhile the value of TNF α,IL 1,IL 6 in blood were assayed according to ELISA method at 1,3,5,7,10 and 14 day postburn.Results All patients showed lower value of gastric pHi than normal at admission(pHi=7.12±0.15).Six patients complicated with MODS presented lower pHi than non MODS (mean pHi=7.17±0.16),four of them died (mean pHi=7.17±0.13)with higher value of serum IL 1,IL 6 and TNF α than the survival.Conclusions Monitoring of gastric pHi may reflect the tissue inadequacy of oxygenation and predict major complications with high sensitivity to the patients with severe burn.
出处
《北京医学》
CAS
北大核心
2002年第5期315-317,共3页
Beijing Medical Journal
