重症脑卒中患者胃肠道衰竭的预防性治疗对预后的影响

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1、358翌njryndFunctionalReconstruction，September2010，Vo1．5，No．5[DOII10．3870／sjsscj．2010．05．011·论著·重症脑卒中患者胃肠道衰竭的预防性治疗对预后的影响陈晨，彭涛#1．郑州大学第一附属医院老年病科，郑州450052；2．郑州大学第一附属医院神经内科，郑州450052【摘要】目的：探讨重症脑卒中患者胃肠道衰竭的发生率及预防性予以胃肠道保护治疗对预后的影响。方法：重症脑卒中患者328例随机分为2组；预防组154例，预防性予以抑酸、保护胃粘膜和胃肠动力药物治疗；对照组174例，在出现胃肠道衰竭时予

2、以同样药物治疗。观察2组患者胃肠道衰竭、多脏器功能衰竭(MODS)的发生率和预后情况。结果：预防组患者胃肠道衰竭86例(55．84)，MODS64例(41．56)，死亡19例(12．34)；对照组患者胃肠道衰竭l12例(64．37)，MODS95例(54．60)，死亡44例(25．29)。2组胃肠道衰竭发生率无差别，但预防组MODS发生率和死亡率低于对照组。结论：重症脑卒中患者发生胃肠道衰竭机率高(6O．37)，预防性治疗不能降低胃肠道衰竭的发生率，但可以降低MODS的发生率和死亡率。【关键词】重症；脑卒中；胃肠道衰竭；预后【中图分类号】R741；R741．05【文献标识码

3、】A【文章编号11001—117X(2010)05—0358—03EffectsofProphylacticTreatmentofGastrointestinalTractFailureonPrognosisofPatientswithCriticalCerebralApoplexyCHENChen▲，PENGTao．▲DepartmentofGerontology．theFirstAffiliatedHospitalofZhengzhouUniversity，Zhengzhou450052，China[Abstract]Objective：Toexploretheinci

4、dencerateofgastrointestinaltractfailureandtheeffectsofprophylactictreatmentofgastrointestinaltractfailureonprognosisofcriticalcerebralapoplexypa—tients．Methods：238casesofcriticalcerebralapoplexypatientswererandomlydividedintotreatmentgroup(”一154)andcontrolgroup(一174)．Thepatientsinthetreatm

5、entgroupweretreatedwithantigastricacid，gastricmucosaprotectionandstomachintestinedynamicdrugsprophylacticlywhilepatientsincontrolgroupwerenottreatedwiththesamedrugsuntiltheyweredigestedgastrointestinaltractfail—ure．Theincidencerateofgastrointestina1tractfailure，mutipleorgansdisfunctionsynd

6、rome(MODS)andprognosisofthetwogroupswereanalyzed．Results：Intreatmentgrouptheincidentrateofgastro—intestina1tractfailure，MODSandmortalitywas86(55．84)，64(41．56)and19(12．34)respec—tivelyandincontrolgroupwas112(64．37)，95(54．60)and44(25．29)respectively．Therewasnodifferencebetweenthetwogroupsinc

7、auseofincidencerateofgastrointestinaltractfailurebutthein—cidencerateofMODSandmortalityoftreatmentgroupwerelessthanthatofthecontrolgroup．Conclu—sion：Theincidencerate(60．37)ofgastrointestinaltractfailurewasconsiderablyhighincritacalcere—bralapoplexypatients．Pro