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目的:比较静脉滴注0.5 mg/kg和1.0 mg/kg两种剂量奥美拉唑对危重患儿胃内pH、消化道出血及不良反应的影响。方法:选取2011年2月至2014年12月我院儿科综合重症监护室消化道出血危重患儿64例,随机分为A、B两组各32例,A组患儿静脉滴注0.5 mg/kg奥美拉唑,B组患儿静脉滴注1.0 mg/kg奥美拉唑,观察患儿用药后48 h内的胃内pH、pH>4的时间百分比及不良反应等。结果:奥美拉唑治疗后患儿胃内pH>4的时间占研究总时间的57.8%;两组患儿24~48 h胃内pH>4的时间百分比及平均胃内pH均明显高于0~24 h(P<0.01);B组24~48 h胃内pH>4时间百分比明显高于A组(P<0.05);B组患儿血浆奥美拉唑水平高于A组,但B组患儿血浆奥美拉唑水平和胃内pH无明显相关性。结论:静脉滴注0.5 mg/kg和1.0mg/kg两种剂量奥美拉唑在24 h内对胃内pH均未实现足够的碱化。对于24~48 h胃内pH>4时间百分比,1.0 mg/kg剂量组明显高于0.5 mg/kg剂量组。
OBJECTIVE: To compare the effects of omeprazole 0.5 mg / kg and 1.0 mg / kg intravenously on gastric pH, gastrointestinal bleeding and adverse reactions in critically ill children. Methods: From February 2011 to December 2014, 64 pediatric patients with critical gastrointestinal bleeding in pediatric intensive care unit of our hospital were randomly divided into two groups (A and B), 32 cases in each group. A group received intravenous drip of 0.5 mg / kg omeprazole. Group B received omeprazole 1.0 mg / kg intravenously. The intragastric pH, the time percentage of pH> 4 and the adverse reaction within 48 hours after treatment were observed. Results: The intragastric pH> 4 of omeprazole treatment accounted for 57.8% of the total study time. The time percentage and average intragastric pH of gastric pH> 4 in 24-48 h were significantly higher in both groups (P <0.01). The percentage of gastric pH> 4 in group B was significantly higher than that in group A at 24-48 h (P <0.05). The level of plasma omeprazole in group B was higher than that of group A The plasma level of omeprazole in group B had no significant correlation with the intragastric pH. CONCLUSION: Both omeprazole 0.5 mg / kg and 1.0 mg / kg are not adequately alkalized in the stomach within 24 h. For the 24 h to 48 h gastric pH> 4 time percentage, the 1.0 mg / kg dose group was significantly higher than the 0.5 mg / kg dose group.