| 摘要: |
| 目的：研究质子泵抑制剂（PPI）预防骨科择期手术患者应激性溃疡的效果及并发症，对其合理应用提出建议。方法：回顾性分析择期骨科手术 500 例患者的资料，比较短期及长期服用 PPI 及 H2RA 发生应激性溃疡及社区获得性肺炎的比例，比较长期应用 PPI 患者在服用前后骨密度的变化。结果：PPI 与 H2RA 比较，在预防应激性溃疡方面，长疗程组和短疗程组，差异均无统计学意义（P>0.05）；在社区获得性肺炎方面，长疗程组内，差异有统计学意义（P<0.05）。短疗程组内，差异无统计学意义（P>0.05）。比较奥美拉唑、兰索拉唑及泮托拉唑预防应激性溃疡的疗效无差别（P>0.05）；三者在导致社区获得性肺炎方面差异亦无统计学意义（P>0.05）。服用 PPI 3 个月患者服用前后骨密度比较，PPI 组与H2RA 组，差异有统计学意义（P<0.05）。结论：对于骨科择期手术患者，建议短期应用奥美拉唑预防应激性溃疡。 |
| 关键词: 应激性溃疡 社区获得性肺炎 质子泵抑制剂 骨密度 骨科手术 |
| DOI：10.3969/j.issn.1007-6948.2019.04.017 |
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| 基金项目: |
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| Effect of Proton Pump Inhibitors in Prevention of Stress Ulcer in Orthopaedic Patients with Elective Surgical Procedures |
| ZHOU Yi-zhai,BAN Zhi-chao,ZHU Hao |
| Baoding Second Central Hospital, Baoding (072750), China |
| Abstract: |
| Objective To study the effect and complication of proton pump inhibitors in precaution of stress ulcer in orthopaedic patients with elective surgical procedures, and to table a proposal for the rational use of proton pump inhibitors. Methods Retrospective analysis was performed for the data of 500 patients after selective operation. The rates of stress ulcer and community acquired pneumonia in short-term and long-term PPI and H2RA were compared, and the changes of bone mineral density before and after long-term PPI treatment were compared. Results Compared with H2RA, PPI and H2RA showed no statistically signi?cant difference in the prevention of stress ulcer in the long-course group and short-course group (P>0.05). In terms of community acquired pneumonia, the long treatment group showed statistically signi?cant difference (P <0.05). In the short course group, the difference was not statistically significant. The efficacies of omeprazole, lansoprazole and pantoprazole in the prevention of stress ulcer were not different (P>0.05), and there was no signi?cant difference in the cause of community acquired pneumonia (P>0.05). The bone mineral density of the patients treated with PPI for 3 months was 0.007 in the PPI group and 0.037 in the H2RA group, and the difference was statistically significant (P <0.05). Conclusion Short-term use of omeprazole could prevent stress ulcers, and reduce the proportion of the drug and the occurrence of complications. |
| Key words: Stress ulcer bleeding hospital-acquired pneumonia proton pump inhibitors bone mineral density orthopaedic operation |
