目的：观察急诊重症监护室中危重脑出血患者，使用不同时间奥美拉唑后医院获得性肺炎（ HAP）的发生率。方法急诊重症监护室96例危重脑出血的患者，根据奥美拉唑的使用时间随机分为A、B、C 3组，各组分别使用奥美拉唑（40 mg，静滴，1次/天）3天、7天、14天。患者每日于使用奥美拉唑1 h后抽取胃液测定pH值，实验开始后头3天每日留1次痰细菌培养和胃液细菌培养。结果 A、B、C各组应激性溃疡出血的发生率分别为18.8％、12.5％、6.3％。各组HAP发生率分别为31.3％、40.6％、46.9％。与其它组比较，使用奥美拉唑14天的C组胃液pH值更高（P＜0.05），应激性溃疡出血发生率更低（P＜0.05），但HAP发生率更高（P＜0.05）。结论对于危重脑出血患者，使用适当疗程的奥美拉唑能够通过维持适度胃液pH值，既减少应激性溃疡出血的发生，也减少HAP的发生。%Objective To obseve the incidence of hospital acquired pneumonia ( HAP) in critically ill patients with cerebral hemorrhage whom use varies course of omeprazole.Methods 96 cases of acute cerebral hemorrhage were ran-domly divided into three groups according to the tratment course of omeprazole ( each group′s course of treatment are 3 days, 7 days, 14 days,the dosage is 40mg per day).PH value of gastric juice in patients were tested after treatment of omeprazole everyday and sputum and gastric juice bacterial were cultured daily in first three days .Results The inci-dence of stress ulcer bleeding in group ABC were respectively 18.8%, 12.5%, 6.3%,while the incidence of HAP were respectively 31.3%, 40.6%, 46.9%.Compare to other groups ,the gastric juice pH values in group C is higher , the in-cidence of stress ulcer bleeding in group C is lower ,meanwhile the incidence of HAP in group C is higher.Conclusions For critically ill patients with cerebral hemorrhage ,the proper course of omeprazole can also prevent the complications of stress ulcer bleeding and HAP.
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