CAJ | 학술논문

[目的]了解神经外科 ICU病人胃液pH值、胃蛋白酶含量及胃内细菌定植与呼吸道感染的关系,为临床给予及时的有效护理干预措施提供依据。[方法]选取北京市某三级甲等医院神经外科 ICU病人进行连续3 d的病情观察,并采集胃液进行 pH值、胃蛋白酶含量检测及细菌培养,采集气管分泌物进行细菌培养。[结果]纳入47例病人,共收集235例次,胃液pH值为2.5~8.0(5.54±1.02)；胃液 pH 值随 ICU入住时间逐渐增加,酸度逐渐下降；胃液中胃蛋白酶含量为3.766 ng/mL~84.482 ng/mL,与胃液pH值呈负相关(r=-0.939,P<0.001)；76.6%病人胃液中含有定植菌,85.1%病人痰液中含有定植菌,病人胃液中细菌定植菌落与呼吸道细菌菌落呈现一致的比例为57.4%。[结论]对ICU重症病人进行胃液pH值监测,可动态观察病人的病情变化,及时合理地调节胃液的酸碱度,将胃液pH值控制在适当的范围,对于病人的治疗和预后具有重要意义。
[목적]료해신경외과 ICU병인위액pH치、위단백매함량급위내세균정식여호흡도감염적관계,위림상급여급시적유효호리간예조시제공의거。[방법]선취북경시모삼급갑등의원신경외과 ICU병인진행련속3 d적병정관찰,병채집위액진행 pH치、위단백매함량검측급세균배양,채집기관분비물진행세균배양。[결과]납입47례병인,공수집235례차,위액pH치위2.5~8.0(5.54±1.02)；위액 pH 치수 ICU입주시간축점증가,산도축점하강；위액중위단백매함량위3.766 ng/mL~84.482 ng/mL,여위액pH치정부상관(r=-0.939,P<0.001)；76.6%병인위액중함유정식균,85.1%병인담액중함유정식균,병인위액중세균정식균락여호흡도세균균락정현일치적비례위57.4%。[결론]대ICU중증병인진행위액pH치감측,가동태관찰병인적병정변화,급시합리지조절위액적산감도,장위액pH치공제재괄당적범위,대우병인적치료화예후구유중요의의。
Objective:To know about the relationship among pH value of gastric fluid,pepsin,bacterial colonization and respiratory infections in ICU patients in Neurosurgical department,so as to provide reference for clinical effective care interventions timely.Methods:The neurosurgical ICU patients in a three grade A hospital in Beij ing city were selected for lasting 3 days on observation on patients’condition,and the gastric juice was collected for pH value,pepsin testing and bacterial culturing,and to collect tracheal secretions for bacterial culturing.Results:47 cases of patients were included and totally 235 cases times were collected,and the pH value of gastric juice was 2.5~8.0,an average of 5.54±1.02.Gastric pH value gradually increased and the acidity decreased with the increace of length of ICU stay.The pepsin content in gastric juice was 3.766 ng/mL~84.482 ng/mL,and it was negatively correlated to gastric pH value (r= 0.939,P<0.001).76.6% of patients had gastric colonization,85.1% of patients had sputum bacterial coloniza-tion,and their consistency ratio was 57.4%.Conclusion:Gastric pH monito-ring for ICU severe patients is helpful to observe the patient’s condition changes dynamicly,and timely and reasonablely regulate the gastric pH. Gastric pH control in the appropriate range is important for the treatment and prognosis of the patients.