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目的探讨不同剂量质子泵抑制剂预防呼吸机相关性肺炎的临床效果。方法选择2013年10月至2014年10月符合诊断标准的呼吸机相关性肺炎患者60例,依据奥美拉唑剂量分为低剂量组(20 mg)、中剂量组(40 mg)和高剂量组(60 mg),每组20例。三组奥美拉唑剂量加入100 ml氯化钠注射液静脉滴注,比较其用药前、用药48 h的胃液p H值及应激性溃疡、呼吸机相关性肺炎发生率。结果三组患者胃液p H值用药前与用药48 h比较,差异有统计学意义(P<0.05);用药48 h胃液p H值中剂量组与高、低剂量组比较,差异有统计学意义(P<0.05)。中剂量组(40 mg奥美拉唑)应激性溃疡发生率(10%)低于低剂量组(20%),差异有统计学意义(P<0.05)。中剂量组呼吸机相关性肺炎发生率(10%)与低剂量组(10%)相等;但低于高剂量组(20%)。结论奥美拉唑中剂量组(40 mg)能较好预防呼吸机相关性肺炎,同时又能降低应激性溃疡的发生率。
Objective To investigate the clinical effects of different doses of proton pump inhibitors in preventing ventilator-associated pneumonia. Methods Sixty patients with ventilator-associated pneumonia who met the diagnostic criteria from October 2013 to October 2014 were divided into two groups according to the dose of omeprazole: low dose (20 mg), middle dose (40 mg) and high dose Group (60 mg), 20 cases in each group. Three doses of omeprazole were added into 100 ml sodium chloride injection by intravenous drip. The p H value, stress ulcer and ventilator-associated pneumonia in gastric juice 48 h before treatment were compared. Results The p value of gastric juice in the three groups before treatment was significantly higher than that of the control group at 48 h (P <0.05). There was a significant difference (P <0.05). The incidence of stress ulcer (10%) in the middle-dose group (40 mg omeprazole) was lower than that in the low-dose group (20%) (P <0.05). The incidence of ventilator-associated pneumonia in the middle-dose group (10%) was equal to the low-dose group (10%) but lower than the high-dose group (20%). Conclusion Omeprazole medium dose (40 mg) can prevent ventilator associated pneumonia better, and reduce the incidence of stress ulcer.