CAJ | 학술논문

目的：研究危重患者使用质子泵抑制药奥美拉唑的合理疗程,提高患者预后,减少重症监护室( ICU)住院时间及治疗费用。方法：180例APACHEⅡ>10分且机械通气>48 h的ICU危重患者随机分为3组,分别使用奥美拉唑1 d、3 d、5 d等不同疗程。比较3组患者应激性溃疡和消化道出血发生率、呼吸机相关性肺炎( VAP)发生率,以及三组ICU住院时间及治疗费用。结果：3 d、5 d组应激性溃疡和消化道出血发生率均明显低于1 d组(P<0.05)；VAP发生率3 d组最低,与1 d、5 d组比较,差异均有统计学意义(P<0.05)；三组间ICU住院时间及治疗费用比较均差异明显(P<0.05),3 d组ICU住院时间最短,治疗费用最少。结论：奥美拉唑3d疗程较合理,不仅可预防危重患者发生应激性溃疡和消化道出血,且可降低VAP发生率低,ICU住院时间短,治疗费用少。
목적：연구위중환자사용질자빙억제약오미랍서적합리료정,제고환자예후,감소중증감호실( ICU)주원시간급치료비용。방법：180례APACHEⅡ>10분차궤계통기>48 h적ICU위중환자수궤분위3조,분별사용오미랍서1 d、3 d、5 d등불동료정。비교3조환자응격성궤양화소화도출혈발생솔、호흡궤상관성폐염( VAP)발생솔,이급삼조ICU주원시간급치료비용。결과：3 d、5 d조응격성궤양화소화도출혈발생솔균명현저우1 d조(P<0.05)；VAP발생솔3 d조최저,여1 d、5 d조비교,차이균유통계학의의(P<0.05)；삼조간ICU주원시간급치료비용비교균차이명현(P<0.05),3 d조ICU주원시간최단,치료비용최소。결론：오미랍서3d료정교합리,불부가예방위중환자발생응격성궤양화소화도출혈,차가강저VAP발생솔저,ICU주원시간단,치료비용소。
Objective: To study the rational treatment course of proton pump inhibitor omeprazole for critical patients in order to improve the prognosis and reduce the hospital stay and treatment expense. Methods:Totally 180 critical patients with APACHEⅡ>10 and mechanical ventilation >48 hours in ICU were selected and randomly divided into 3 groups treated by omeprazole for 1 day, 3 days and 5 days , respectively. The incidence rate of stress ulcer, gastrointestinal hemorrhage and ventilator-associated pneumonia ( VAP) in the three groups was studied, and the ICU stay and expense were also investigated. Results:The incidence rate of stress ul-cer and gastrointestinal hemorrhage in the group with treatment course of 3 days and 5 days were significantly lower than those in the group with 1 day treatment(P<0. 05). The incidence rate of VAP with 3-days treatment was the lowest, compared with 1 day and 5 days treatment, the different was satatistically significant(P<0. 05). The ICU hospitalization time and treatment expense were also significantly different among the three groups, and that in 3-days, group was the lowest(P<0. 05). Conclusion:The 3-day treatment is the most reasonable, which can not only prevent stress ulcer and gastrointestinal bleeding in critical patients, but also reduce the in-cidence of VAP with lowered hospital stay and expense.