泮托拉唑术前给药预防颅脑外伤术后并发应激性溃疡的效果

摘要

目的 观察手术前应用泮托拉唑对预防重度颅脑外伤术后并发应激性溃疡(SU)的效果.方法 选择急诊因重度颅脑外伤行开颅手术患者120例,随机分成A、B两组.麻醉诱导前A组静脉滴注泮托拉唑40 mg,B组不予滴注泮托拉唑.术后在常规治疗的同时,两组均给予泮托拉唑40 mg静脉滴注.观察并记录两组诱导前(T1)、手术1 h(T2)、术毕(T3)、术后第1 d(T4)、第2 d(T5)各时点患者胃液pH值、胃液红细胞计数及发生SU的例数.结果 A组胃液pH值在T2～T4时均高于B组(P＜0.05);A组发生1例SU(1.66%),B组发生8例SU(13.33%).结论 急诊重度颅脑外伤手术患者,术前应用泮托拉唑能有效降低术后SU的发生率.%Objective To observe the effects of preoperative application with pantoprazole on the prevention of stress ulcer ( SU )after the operation for severe craniocerebral trauma. Methods 120 cases of severe craniocerebral trauma receiving emergency craniotomy were selected and randomly divided into two groups( A and B ). Before anesthesia induction, group A received intravenous infusion with 40 mg pantoprazole,but group B did not receive such infusion. After the surgery,the two groups received the conventional treatment and intravenous infusion with 40 mg pantoprazole. Observation and recording were made in pH value of gastric juice, red blood cell count in gastric juice and number of cases with SU in the two groups at the following time points: before the induction( T1 ), 1 h after the beginning of the surgery( T2 ), at the end of the surgery( T3 ), d 1 after the surgery( T4 ), and d 2 after the surgery( T5 ). Results The pH value of gastric juice in group A was higher than that in group B during the time points from T2 to T4( P <0. 05 ). One case of SU occurred in group A( 1. 66% ) ,and 8 ones occurred in group B( 13. 33% ). Conclusion For the patients receiving emergency operation for severe craniocerebral trauma, preoperative application with pantoprazole can effectively reduce the incidence of postoperative SU.