Relationship between gastrointestinal and pulmonary infection with PPIs in severe craniocerebral injury patients
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摘要: 目的 分析重症颅脑损伤患者使用质子泵抑制剂(PPIs)出现胃肠道感染、医院获得性肺炎(HAP)的发生率,探讨重症颅脑损伤患者如何正确使用PPIs。 方法 查阅2011—2012年入院的141例重症颅脑损伤患者的病历,按未使用PPIs(17例)、长时间使用PPIs(59例)与短时间使用PPIs(65例)分为3组,并对使用PPIs后相关感染风险因素进行分析。 结果 使用PPIs组中胃肠道感染、HAP发生率较高,特别是长时间(超过9 d)使用者。用不同多变量的logistic回归分析,经GCS评分校正后,长时间使用PPIs是一风险因素。 结论 长时间使用PPIs可能是重症颅脑损伤患者胃肠道感染及HAP的风险因素之一。临床使用PPIs时,除考虑病情外,还应注意使用时间。Abstract: Objective To analyze the occurrence rate of gastrointestinal and pulmonary infection and hospital acquired pneumonia (HAP)in severe craniocerebral injuries in my hospital using proton pump inhibitors (PPIs),discuss the right way to use PPIs for severe craniocerebral injuries. Methods The case histories of 141 severe craniocerebral injuries in my hospital from 2011 to 2012 were looked up,and divided into three groups as follows:the group that never used PPIs(17 cases),the group that used PPIs for a long time (59 cases),and the group that used PPIs for a short time (65 cases),and the risks of getting infected using PPIs were analyzed in those three groups above. Results The patients in PPIs group had a higher risk of gastrointestinal tract infection and HAP,especially who were treated with PPIs more than 9 days.Adjusted by GCS score,using PPIs for a long time was a risk factor in different multivariate logistic. Conclusion Using PPIs for a long time might be a risk factor of gastrointestinal tract infection andHAP.Therefore,apart from considering the state of illness,more attention should be paid to the using time when use PPIs.
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Key words:
- severe traumatic brain injury /
- proton pump inhibitors /
- risk factors
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[1] 王小蕾,王蔚虹.长期服用质子泵抑制剂需要关注的临床问题[J].临床药物治疗杂志,2009,7(4):6-11. [2] 钟天安,王建奇,姚鹏飞,等.重型颅脑损伤后应激性溃疡防治与胃肠道感染的相关性及对策[J].中华神经医学杂志,2006,5(8):823-825. [3] 钱素卿,牛慧云.SPSS 软件在医药学科研工作中的应用[J].中国误诊学杂志,2010,10(16):4022-4023. [4] 刘明铎,王伟民,王国良.实用颅脑损伤学[M].北京:人民军医出版社,2003:373-374. [5] 高英丽,朱京慈.颅脑损伤后应激性溃疡的发病机制及预防[J].中国创伤杂志,2005,21(6):478-479. [6] Leonard J,Marshall JK,Moayyedi P.Systematic review of the risk of enteric infection in patients taking acid suppression[J].Am J Gastroenterol,2007,102(9):2047-2056. [7] 苏惠崧,贾 青,赵 蓉,等.益生菌联合肠内营养对重度颅脑损伤病人的疗效观察[J].肠外与肠内营养,2011,18(4):235-237. [8] 吴在德,吴肇汉.外科学[M].6版.北京:人民卫生出版社,2003:268. [9] 张 波,丁美修.重型颅脑损伤并发肺部感染与GCS 评分和预后关系探讨[J].中国厂矿医学,2001,14(1):8-9. [10] Herzig SJ,Howell MD,Ngo LH,et al.Acid-suppressive medication use and the risk for hospital-acquired pneumonia[J].JAMA,2009,301(20):2120-2128. [11] Gulmez SE,Holm A,Frederiksen H,et al.Use of proton pump inhibitors and the risk of community-acquired pneumonia:a population-based case-control study[J].Arch Intern Med,2007,167(9):950-955. [12] Eom CS,Jeon CY,Lim JW,et al.Use of acid-suppressive drugs and risk of pneumonia:a systematic review and meta-analysis[J].CMAJ,2011,183(3) :310. [13] Martindale RG.Contemporary strategies for the prevention of stress-related mucosal bleeding[J].Am J Health Syst Pharm,2005,62(suppl2):s11-s17. [14] 中华医学杂志编辑委员会.应激性溃疡防治建议[J].中华医学杂志,2002,82(14):1000-1001. [15] 李允美,纪淑琴,庄玉珍.根据胃液pH值应用抑酸剂对重症患者应激性溃疡的预防作用[J].山东医药,2005,45(12):57.
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