摘要
目的 探讨应用氢氧化铝凝胶与山莨菪碱注射剂等混合后早期鼻饲,防治重型颅脑损伤患者上消化道出血的疗效。方法重型颅脑损伤患者1113例分为3组。对照组410例,伤后72 d内无任何预防上消化道出血措施;A组540例使用静脉或管喂甲氰咪胍、雷尼替丁、奥美拉唑;B组163例,管喂氢氧化铝凝胶和山莨菪碱混合剂163例。比较3组上消化道出血的发生率。结果 B组上消化道出血的发生率为1.25％,与A组和对照组比较(P<0.01)均明显降低,需输血治疗例数及其用血量和死亡率也有同步下降。全组未发现管喂药物后所导致的胃肠返流。结论 氢氧化铝疑胶与山莨菪碱注射剂等混合后早期鼻饲对防治重型颅脑损伤消化道出血具有重要临床应用价值。
Objective To study the effect of early administration of a mixture of Anisodamine and A-luminium hydroxide gel via nasal gastric tube in preventing in stress - induced digestive tract bleeding in patients with severe brain damage. Method One thousand one hundred and thirteen patients with severe brain damage were divided into three groups: control group 410 cases without any measures to prevent digestive tract bleeding within 72 hours after injury, treatment group A 540 cases when given cimetidine, ranitidine and Losec by intravenous injection or nasal feeding. Group B 240 cases who received nasal feeding of aniso-damine and Aluminium Hydroxide gel mixture. The incidence of bleeding in each group was recorded . Results The incidence of the upper digestive tract bleeding in group B is 1.25% , compared with that of control group( x2 = 90. 13, P < 0. 01) , while with that of group A ( x2 = 12. 32, P < 0. 01) , the incidence of bleeding in group B is distinctively lower than that in other two groups. The number of the patients requiring transfusion and the amount of the blood needed as well as the mortality in group B decline simultaneously. The symptom of reflex of gastroenteric contents possibly caused by tube feeding was not found in all these groups. Comparing group A with control group:x2 =38. 36,P<0.01 and the incidence of bleeding in group A also has a significant decline. Conclusion To prevent the stress induced upper GI bleeding in patients with severe brain damage should not be limited in raising the pH value of the gastric juice only but should also be focused on improving the blood irrigation to the gastric mucosa, in order to ameliorate its acute pathological changes. The general clinical effective rate of tube feeding with anisodamine and aluminium hydroxide gel mixture reaches 98. 75%. The ulcer inhibiting rate in animal experiment has been reported to be 79. 1%. It has a significant practical value in the prevention and cure of the digestive bleeding in those patients suffered from severe brain damage
出处
《中华消化内镜杂志》
2002年第6期354-356,共3页
Chinese Journal of Digestive Endoscopy
关键词
消化性溃疡出血
应激
预防
脑损伤
Peptic ulcer hemorrhage
Stress
Brain Injuries
Prevntion
