目的 探討奧美拉唑在嬰幼兒胸腔鏡體外循環(huán)(CPB)心臟手術(shù)中對(duì)胃腸道的保護(hù)作用。 方法 將127例先天性心臟病患者（年齡3～12歲）隨機(jī)分為3組，實(shí)驗(yàn)組A和實(shí)驗(yàn)組B：行胸腔鏡微創(chuàng)手術(shù)治療，對(duì)照組：行常規(guī)手術(shù)治療；實(shí)驗(yàn)組A在CPB預(yù)充液中給予奧美拉唑10 mg，實(shí)驗(yàn)組B和對(duì)照組均注入等量生理鹽水。3組均于術(shù)前、CPB 30min、CPB結(jié)束、術(shù)后4h、24h進(jìn)行胃液常規(guī)檢查，并采集血液標(biāo)本，用ELISA法測(cè)定血清促胃液素。 結(jié)果 與CPB前比較：實(shí)驗(yàn)組A胃液pH值較CPB結(jié)束后有明顯升高(P lt;0.01)，實(shí)驗(yàn)組B于術(shù)畢有明顯降低(P lt;0.05)，對(duì)照組于術(shù)后4h較術(shù)前有明顯降低(P lt;0.05); 3組胃液紅細(xì)胞計(jì)數(shù)及血清促胃液素與CPB前比較均有明顯上升(P lt;0.01)。與對(duì)照組比較：實(shí)驗(yàn)組A胃液pH于CPB 結(jié)束后各時(shí)間點(diǎn)較對(duì)照組有明顯上升，而胃液紅細(xì)胞計(jì)數(shù)則有明顯下降，血清促胃液素于CPB 30 min時(shí)即較其它兩組有明顯降低。實(shí)驗(yàn)組B胃液pH于術(shù)畢有明顯降低，但術(shù)后24h恢復(fù)至術(shù)前水平，同時(shí)間點(diǎn)胃液紅細(xì)胞計(jì)數(shù)與促胃液素則有明顯降低。 結(jié)論 兒童胸腔鏡心臟手術(shù)中CPB時(shí)間較常規(guī)手術(shù)時(shí)間長(zhǎng)，需要在此期間進(jìn)行胃腸道保護(hù)，術(shù)后各項(xiàng)指標(biāo)恢復(fù)較常規(guī)手術(shù)時(shí)間短
引用本文： 魏旭峰,董小超,楊劍等. 兒童胸腔鏡心臟手術(shù)中奧美拉唑?qū)ξ改c道的保護(hù)作用. 中國(guó)胸心血管外科臨床雜志, 2007, 14(6): 429-. doi: 復(fù)制
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| 5. | Thomson JD, Aburawi EH, Watterson KG, et al. Surgical and transcatheter (Amplatzer) closure of atrial septal defects: a prospective comparison of results and cost. Heart,2002,87(5):466-469. |
| 6. | Apple FS, Wu AH. Myocardial infarction redefined: role of cardiac troponin testing. Clin Chem, 2001,? 47(3):377-379. |
| 7. | 俞世強(qiáng)，程云閣,蔡振杰,等. 胸腔鏡心臟手術(shù)并發(fā)癥分析. 第四軍醫(yī)大學(xué)學(xué)報(bào), 2003,24(3):263-264. |
| 8. | Sartori S, Trevisani L, Nielsen I, et al. Randomized trial of omeprazole or ranitidime versus placebo in the prevention of chemotherapy induced gastroduodenal injury. J Clin Oncol, 2000, 18(3):463-467. |
| 9. | Fornai M, Natale G, Colucci R, et al. Mechanisms of protection by pantoprazole against NSAID-induced gastric mucosal damage. Naunyn Schmiedebergs Arch Pharmacol, 2005,372(1):79-87. |
| 10. | Handa O, Yoshida N, Fujita N, et al. Molecular mechanisms involved in anti-inflammatory effects of proton pump inhibitors. Inflamm Res,2006,55(11):476-480. |
| 11. | Olbe L, Cederberg C, Lind T, et al. Effect of omeprazole on gastric acid secretion a plasma gastrin man. Scand J Gastroenterol,1989,166(Suppl):27-32. |
| 12. | Hou W, Schubert ML. Gastric secretion. Curr Opin Gastroenterol, 2006,22(6):593-598. |
| 13. | Sikiri′c P, Seiwerth S, Deskovi′c S, et al. New midel of cytoprotection/adaptive cytoprotection in rats: endogenous small irritants,antiulcer agents and indomethacin. Eur J Pharmacol, 1999,364(1):23-31. |
| 14. | 徐鵬，易定華.兔體外循環(huán)對(duì)促胃泌素及其受體的影響. 第四軍醫(yī)大學(xué)學(xué)報(bào), 2000, 21(4):502-504. |
- 1. Mercado PD, Farid H, O’Connell TX, et al. Gastrointestinal complications associated with cardiopulmonary bypass procedures. Am J Surg,1994,60(10):789-792.
- 2. Tsiotos GG, Mullany CJ, Zietlow S, et al. Abdominal complications following cardiac surgery. Am J Surg, 1994,167(6):553-557.
- 3. Nakamoto H, Suzuki T, Sugahara S, et al. Successful use of thoracoscopic pericardiectomy in elderly patients with massive pericardial effusion caused by uremic pericarditis. Am J Kidney Dis,2001,37(6):1294-1298.
- 4. Schoreyers P, Wellens F, De Geest R, et al. Minimally invasive video-assistedo mitral valve repair: short and mid-term results. J Heart Valve Dis, 2001,10(5):579-583.
- 5. Thomson JD, Aburawi EH, Watterson KG, et al. Surgical and transcatheter (Amplatzer) closure of atrial septal defects: a prospective comparison of results and cost. Heart,2002,87(5):466-469.
- 6. Apple FS, Wu AH. Myocardial infarction redefined: role of cardiac troponin testing. Clin Chem, 2001,? 47(3):377-379.
- 7. 俞世強(qiáng)，程云閣,蔡振杰,等. 胸腔鏡心臟手術(shù)并發(fā)癥分析. 第四軍醫(yī)大學(xué)學(xué)報(bào), 2003,24(3):263-264.
- 8. Sartori S, Trevisani L, Nielsen I, et al. Randomized trial of omeprazole or ranitidime versus placebo in the prevention of chemotherapy induced gastroduodenal injury. J Clin Oncol, 2000, 18(3):463-467.
- 9. Fornai M, Natale G, Colucci R, et al. Mechanisms of protection by pantoprazole against NSAID-induced gastric mucosal damage. Naunyn Schmiedebergs Arch Pharmacol, 2005,372(1):79-87.
- 10. Handa O, Yoshida N, Fujita N, et al. Molecular mechanisms involved in anti-inflammatory effects of proton pump inhibitors. Inflamm Res,2006,55(11):476-480.
- 11. Olbe L, Cederberg C, Lind T, et al. Effect of omeprazole on gastric acid secretion a plasma gastrin man. Scand J Gastroenterol,1989,166(Suppl):27-32.
- 12. Hou W, Schubert ML. Gastric secretion. Curr Opin Gastroenterol, 2006,22(6):593-598.
- 13. Sikiri′c P, Seiwerth S, Deskovi′c S, et al. New midel of cytoprotection/adaptive cytoprotection in rats: endogenous small irritants,antiulcer agents and indomethacin. Eur J Pharmacol, 1999,364(1):23-31.
- 14. 徐鵬，易定華.兔體外循環(huán)對(duì)促胃泌素及其受體的影響. 第四軍醫(yī)大學(xué)學(xué)報(bào), 2000, 21(4):502-504.