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目的探讨多潘立酮和奥美拉唑预防鼻饲管肺炎的临床特点及发生机制。方法选取我院2012年1月-2013年12月鼻饲管患者82例,随机分为空白对照组(n=31),不用药;奥美拉唑组(n=27),奥美拉唑一日1次20 mg,晚上睡前鼻饲管注入;多潘立酮组(n=24),多潘立酮每次10 mg,一日3次,每次餐前鼻饲管注入。观察鼻饲管肺炎的发生率、死亡率,抗生素治疗时间及住院时间。结果空白对照组和奥美拉唑组患者鼻饲管肺炎的发生率分别为39.2%、34.6%,均高于多潘立酮组(13.0%),且差异均有统计学意义(P<0.01)。多潘立酮组患者抗生素的平均治疗时间短于空白对照组和奥美拉唑组患者(P<0.05),而平均住院时间与空白对照组和奥美拉唑组差异无统计学意义(P>0.05)。结论胃肠动力药多潘立酮可明显降低鼻饲管肺炎的发病率及缩短住院的抗生素治疗时间。
Objective To investigate the clinical features and mechanism of domperidone and omeprazole in the prevention of nasal feeding tube pneumonia. Methods Eighty-two patients with nasal feeding tube from January 2012 to December 2013 in our hospital were randomly divided into blank control group (n = 31) without medication, omeprazole group (n = 27), omeprazole- Day 20 mg, nasal feeding tube before going to bed at night; domperidone group (n = 24), domperidone 10 mg each time, 3 times a day, each feeding before nasogastric tube. Observe nasal feeding tube pneumonia incidence, mortality, antibiotic treatment time and hospital stay. Results The incidences of nasal feeding tube pneumonia in the blank control group and omeprazole group were 39.2% and 34.6%, respectively, which were higher than those in the domperidone group (13.0%). The difference was statistically significant (P <0.01). The average antibiotic treatment time in domperidone group was shorter than that in blank control group and omeprazole group (P <0.05), but the average length of hospital stay was not significantly different from that in blank control group and omeprazole group (P> 0.05) . Conclusions Domperidone, a gastrointestinal motility drug, can significantly reduce the incidence of nasal feeding tube pneumonia and shorten the duration of antibiotic treatment in hospital.