The Analysis Of Curative Effect Of Omeprazole With Glutamine Etc In Stress Ulcer

Objective: Stress ulcer is a common complication of critical illness in children. It appears vomiting upper gastrointestinal bleeding, perforation. It may occur a few poor prognosis often children with life-threatening. Therefore, in order to find a reasonable and effective treatment methods to improve the cure rate in children we use omeprazole with glutamine and other treatment for stress ulcer in critically ill children. To explore a rational and effective treatment strategies to improve the prognosis in children.Methods: We select the children who in PICU in crisis disease for our study. This period from January 2009 to October 2009. It contains fifty cases. According to the national pediatric emergency pediatric study group developed severe disease cases score (PGIS) determine the severity of the disease in children, such as scores> 90 were divided into non-critical, 70 to 90 were divided into severe, <70 were very critical. All patients had no peptic ulcer disease, liver disease, and other out, coagulation disease, primary disease before the onset of hematemesis and melena. In this 50 cases of Critically ill patients there were 26 boys(52%)and 24 girls(48%), ranging in age from 3 months to 12 years. The primary disease included 13 cases with Guillain-Barre syndrome, 10 cases of severe pneumonia requiring mechanical ventilation, 5 cases of acute laryngotracheal-bronchitis,5 cases of acute drug poisoning,10 cases of purulent meningitis and 3 cases delayed vitamin K absence of intracranial hemorrhage,4 cases of sepsis. 50 patients were divided randomly into treatment group (25 cases )and control group (25 cases ), 25 cases of sex, the age, the incidence of bleeding and the original extent of the indicators showed statistically no significant difference, there is comparability. Removing the incentive for treatment of the primary causes of disease and so on the basis of comprehensive treatment while the control group were given cimetidine 10 ~ 20 mg.kg-1,intravenous infusion, bid. The treatment groups were given Omeprazole, 0.6 ~ 0.8 mg kg-1, intravenous infusion qd; while oral aluminum phosphate gel was added 20g tid; L-glutamine Gualenate sodium particles 0.67g / times tid; Heavy bleeding, according to the children who was given 1.3g tid. 50 cases of pediatric gastric tube insertion in critically ill children, take note of gastric juice,discard the first time 5～10 mL, sterile syringe and then extract juice. Gastric juice was extracted into the bottle 1h, as a specimen. Then test the juice with a precision PH Determination of test paper. To collect gastric juice 3 times a day by a gastric tube. The PH indicator paper were immersed in gastric juice and take out after 1s,compared with the standard color, reading out the gastric juice pH value. Observe children with gastric juice color, fecal occult blood and Heart rate, blood pressure respiratory rate urine. Mind the number of days of stress ulcer bleeding, bleeding to stop time. (Ie, vomiting or stomach tube from the discovery of internal drainage of a brown liquid or bloody fluid specimens occult blood (++) more than the start time to the phenomenon of disappearance of time).Determine the effect : markedly effective: no brown or bloody stomach in liquid, gastric occult blood symptoms disappear within 24 h, 3 d within the fecal occult blood test was negative. Effective: no brown or bloody stomach in liquid, gastric occult blood symptoms disappear within 72h, 5d in fecal occult blood test was negative; valid: symptoms of gastric occult blood has not disappeared after 72h, fecal occult blood test was positive.Results:1 Treatment group was 40% remarkly effective rate, 52% effective rate, 92% of the total effective rate. The control group was 16% remarkly effective rate, 40% effective rate, 60% of the total effective rate of control group. Compared the total effective rate between the two was statistically significant. X2 = 7.018 P<0.05 (P=0.008). The results suggest that glutamine quadruple combination of omeprazole stress ulcer treatment effective than cimetidine. Before and after the treatment group were not found in nausea, vomiting and liver, renal significant changes in function, but also found no other adverse reactions.2 PH value of gastric juice treatment group before treatment (1.40±0.72), after treatment (5.13±0.71) in control group before treatment (1.37±0.68) after treatment (3.70±0.69). The PH of Omeprazole treatment group was significant as against that of control group. t = 6.78 P<0.01. The results suggest that omeprazole quadruple therapy with glutamine is more effective than cimetidine in inhibiting gastric acid secretion.3 Abdominal distension Time: The t test treatment group (1.54±0.64) days, the treatment group (1.98±0.59) days. t =- 2.811 P<0.05 (P= 0.10) The results suggest that the treatment group could shorten the time of abdominal distension.4 Length of stay: After t test treatment group (21.26±6.91) days in the control group (28.12±9.44) days, t = -3.597 P<0.05(P=0.001) was statistically significant by comparing the two. The results suggested that the treatment group could shorten the hospitalization time. 5 Cost: treatment group (11422.24±4901.44)yuan, the control group (17701.76±8379.88)yuan. t =- 3.704 P<0.05 (P=0.001) Compare with the two was statistically significant. The results suggested that omeprazole quadruple therapy with glutamine could reduce the costs of treatment.Conclusion:1 Omeprazole combined with L-glutamine and colloidal aluminum phosphate gel, Bifidobacterium Lactobacillus Enterococcus Bacillus cereus quadruple viable treatment of stress ulcer more effective.2 Omeprazole combined with L-glutamine and other drug could shorten the duration of illness and reduce the hospital costs.3 A combination of drug affordable, effective, no obvious side effects, in the treatment of stress ulcer is worth promoting.