• 第四軍醫(yī)大學西京醫(yī)院 心臟外科 全軍心血管病研究所， 西安 710032;

目的 探討奧美拉唑在嬰幼兒胸腔鏡體外循環(huán)(CPB)心臟手術中對胃腸道的保護作用。 方法 將127例先天性心臟病患者（年齡3～12歲）隨機分為3組，實驗組A和實驗組B：行胸腔鏡微創(chuàng)手術治療，對照組：行常規(guī)手術治療；實驗組A在CPB預充液中給予奧美拉唑10 mg，實驗組B和對照組均注入等量生理鹽水。3組均于術前、CPB 30min、CPB結束、術后4h、24h進行胃液常規(guī)檢查，并采集血液標本，用ELISA法測定血清促胃液素。 結果 與CPB前比較：實驗組A胃液pH值較CPB結束后有明顯升高(P lt;0.01)，實驗組B于術畢有明顯降低(P lt;0.05)，對照組于術后4h較術前有明顯降低(P lt;0.05); 3組胃液紅細胞計數(shù)及血清促胃液素與CPB前比較均有明顯上升(P lt;0.01)。與對照組比較：實驗組A胃液pH于CPB 結束后各時間點較對照組有明顯上升，而胃液紅細胞計數(shù)則有明顯下降，血清促胃液素于CPB 30 min時即較其它兩組有明顯降低。實驗組B胃液pH于術畢有明顯降低，但術后24h恢復至術前水平，同時間點胃液紅細胞計數(shù)與促胃液素則有明顯降低。 結論 兒童胸腔鏡心臟手術中CPB時間較常規(guī)手術時間長，需要在此期間進行胃腸道保護，術后各項指標恢復較常規(guī)手術時間短

引用本文： 魏旭峰,董小超,楊劍等. 兒童胸腔鏡心臟手術中奧美拉唑對胃腸道的保護作用. 中國胸心血管外科臨床雜志, 2007, 14(6): 429-. doi: 復制

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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，程云閣,蔡振杰,等. 胸腔鏡心臟手術并發(fā)癥分析. 第四軍醫(yī)大學學報, 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)對促胃泌素及其受體的影響. 第四軍醫(yī)大學學報, 2000, 21(4):502-504.
  1. 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. 2. 　Tsiotos GG, Mullany CJ, Zietlow S, et al. Abdominal complications following cardiac surgery. Am J Surg, 1994,167(6):553-557.
  3. 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. 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. 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. 6. 　Apple FS, Wu AH. Myocardial infarction redefined: role of cardiac troponin testing. Clin Chem, 2001,? 47(3):377-379.
  7. 7. 　俞世強，程云閣,蔡振杰,等. 胸腔鏡心臟手術并發(fā)癥分析. 第四軍醫(yī)大學學報, 2003,24(3):263-264.
  8. 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. 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. 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. 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. 12. 　Hou W, Schubert ML. Gastric secretion. Curr Opin Gastroenterol, 2006,22(6):593-598.
  13. 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. 14. 　徐鵬，易定華.兔體外循環(huán)對促胃泌素及其受體的影響. 第四軍醫(yī)大學學報, 2000, 21(4):502-504.