The Study of the Pathogenesis and Prevention Measures of Stress Ulcer after Severe Craniocerebral Injury

Objective To explore the pathogenesis and preventive measures of stress ulcer after severe craniocerebral injury. Methods 84 cases of stress ulcer patients after severe craniocerebral injury admitted in our hospital from January, 2010 to January, 2013 (whose hospital stays 7d; normal reduction of intracranial pressure, enteral nutrition support treatment and hemostasis treatment were given to them) were randomly divided into four groups, group A, group B, group C and group D. Group A was given no drug; group B was given antacid pantoprazole; group C was given gastric mucosa protective agent sucralfate and Group D was given pantoprazole and sucralfate. ① The relationship among gastric mucosa PH value (PHi), gastric juice PH value, blood glucose level and bleeding rate and fatality rate of group A were observed and analyzed. ② Gastric juice PH values, stress ulcer's bleeding rate and ulcer healing time of the four groups were observed. Results ①Along with the decreasing of PHi value and PH value and the rising of blood sugar, bleeding rate and fatality rate raised obviously. ② The bleeding rate: The bleeding rate of group A was the highest, and significantly higher than that of B, C, and D group. Group D had the lowest bleeding rate. The pH value of gastric juice: The pH value of gastric juice of group A was the lowest, and significantly lower than that of B, C, and D group. Group D had the highest pH value. Ulcer healing time: The ulcer healing time of group A was the longest, and significantly longer than that of B, C, and D group. Group D had the shortest healing time. Conclusion ①The pathogenesis of stress ulcer after severe craniocerebral injury is related to factors such as sympathetic nerve excitability enhancement, gastric mucosa damage and hyperglycemia. ② With regard to the prevention measures of stress ulcer after severe craniocerebral injury, inhibitory acid drugs and gastric mucosa protectant should be given to patients who have received normal reduction of intracranial pressure, enteral nutrition support treatment and hemostasis treatment, which can reduce the bleeding rate and fatality rate of the patients better.