摘要
目的 探讨大手术后危重患者胃粘膜pH值(pHi)的变化与预后及并发症的关系。方法 对63例大手术后危重患者收入ICU,在 12、24、48、72 h连续监测 pHi的变化,存活者随访至出院,死亡者至临终状态。结果 与 11例死亡病人比较,52例存活者中 pHi降低明显为少,25％比 100％,存活者 pHi正常明显居多,75％比 0,P<0.01,pHi以 7.35为界值,低于此值不正常。存活组:pHi<7.35(含先正常后低)13例,并发症 10例(10/13),pHi>7.35(含先低后正常)39例,并发症 17例(17/39)。死亡组:pHi<7.35并呈持续降低 9例,先正常后降低 2例。对 pHi总减低者其死亡预测的敏感性为 100％,特异性为75％,准确性为88％,预测并发症的阳性率为76.9％。结论 连续监测pHi的变化其预测病死率的准确性较高,pHi异常者术后并发症发生率高。
Objective To investigate the relationship of the change of gastric mucosa pHi between the prognosis and complication on the major postoperative critical ill patients. Methods 63 cases of major postoper-ative critical ill patients were admitted to ICU. Their pHi were continuous monitoring for 12, 24, 48 and 72 hours respectively. The survival cases were followed up until discharged from hospital, and the dead ones to terminal stage. Results 52 cases of survival comparing with 11 cases of dead ones, the formers pHi declined were de-creased obviously and its ratio was 25% to 100%. The pHi of survival cases were normai in the majority, 75 to 0, P < 0. 01. The boundary value of pHi was 7. 35, less than it were abnormal. In the survival group, 13 cases' pHi were < 7. 35,and the complications were found in 10 cases (10/13). However when pHi > 7. 35,the complications in 17 cases( 17/39). In the dead group, pHi was < 7. 35, and it was reduced continuously in 9 cases. For total pHi decreasing cases, the sensitivity of dead prediction were 100%, specitieity were 75%, accuracy were 88%, the complicated positive r鈚e of prediction was 76. 9%. Conclusion The pHi' change of continuous monitoring is more accurate to predict the mortality. The complicated incidence is higher in the cases with abnormal pHi.
出处
《岭南现代临床外科》
2002年第2期42-44,共3页
Lingnan Modern Clinics in Surgery
关键词
胃粘膜
PH值
危重病人
连续监测
大手术
Gastric mucosa
pH value
Critical ill patient
Continuous monitoring
Major operation
