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目的探讨胃黏膜pH值(pHi)监测在早期预测危重患者发生多器官功能障碍综合征中的价值。方法测量20例危重患者入院和入院24 h的胃黏膜pH值,并根据多器官功能障碍综合征诊断标准[1]将患者分为多器官功能障碍组(A组)和非多器官功能障碍组(B组),其中A组又分为2个器官功能障碍组(A1组)和>2个器官功能障碍组(A2组),分别比较A和B组以及A1和A2组的胃黏膜pH值。结果 20例危重患者入住ICU 24 h后发生多器官功能障碍者9例,2个器官功能障碍者4例,>2个器官功能障碍者5例。A组的胃黏膜pH值低于B组(P<0.01),A2组的胃黏膜pH值低于A1组(P<0.01)。结论胃黏膜pH值水平与危重患者发生多器官功能障碍有相关性,是早期预测多器官功能障碍的重要监测指标之一。
Objective To investigate the value of gastric mucosal pH (pHi) monitoring in the early prediction of multiple organ dysfunction syndrome in critically ill patients. Methods The gastric mucosal pH values of 20 critically ill patients admitted to hospital and admitted to hospital for 24 h were measured and divided into multiple organ dysfunction group (group A) and non-multiple organ dysfunction group according to the diagnostic criteria of multiple organ dysfunction syndrome [1] (Group B). Group A was divided into two groups: organ dysfunction group (A1 group) and organ dysfunction group (A2 group). The gastric mucosal pH values in groups A and B and A1 and A2 groups were compared respectively . Results Nineteen patients with multiple organ dysfunction, four patients with two organ dysfunction, and five patients with> 2 organ dysfunction occurred in 20 patients with critical illness after ICU admission for 24 hours. The pH value of gastric mucosa in group A was lower than that in group B (P <0.01), and the pH value of gastric mucosa in group A2 was lower than that in group A1 (P <0.01). Conclusion The correlation between gastric mucosal pH value and multiple organ dysfunction in critically ill patients is one of the most important indicators for predicting multiple organ dysfunction in the early stage.