质子泵抑制剂预防重型颅脑损伤后与院内获得性肺炎的关系

摘要

目的 探讨重型颅脑损伤患者应用质子泵抑制剂(PPI)预防应激性溃疡后是否增加院内获得性肺炎的发生率.方法 回顾性调查近1年来我院收治的120例住院时间大于7天的重型颅脑损伤患者资料,分析使用PPI与未使用者发生院内获得性肺炎的情况.结果 在120例重型颅脑损伤患者中使用PPI者83例,发生院内获得性肺炎29例,感染率为34.94％,尤其持续使用PPI≥7天者感染率为47.05％;未使用者34例,发生院内获得性肺炎4例,感染率为10.81％.结论 应用PPI预防应激性溃疡的重型颅脑损伤患者院内获得性肺炎发生率明显高于未使用者,长时间持续使用明显高于短时使用.临床应根据患者具体情况选择用药和控制用药时间,以减少院内获得性肺炎发生率,减轻患者痛苦,减少资源浪费.%Objective To investigate whether using proton pump inhibitors (PPI) to prevent stress ulceration increase the incidence of hospital acquired pneumonia (HAP) in severe craniocerebral injury patients.Methods 120 case with severe craniocerebral injury for more than 7 days in our hospital in recent one year were analyzed and compared the incidence of HAP between using PPI and not.Results There were 83 cases using PPI in 120 cases of severe craniocerebral injury and 29 occurring HAP.The infection rate was 34.94％,especially with continued use ≥ 7days it was 47.05％.There were 34 cases without using PPI,4 found occurring HAP.The infection rate was 10.81％.Conclusions The incidence rate of HAP in patients with severe craniocerebral injury using PPI is significantly higher than that of those without using PPI.And incidence rate of HAP in the long-term use of PPI is obviously higher than the short-term one.The clinical doctors should choose drug and control drug using time according to the specific situation of patients,to reduce the incidence of HAP,and relieve pain of patients and reduce waste of resources.