Gon Shigeyoshi, Irie Yoshihito, Takahashi Morio
Department of Cardiovascular Surgery, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Saitama, Japan.
Jpn J Thorac Cardiovasc Surg. 2006 Jul;54(7):278-84. doi: 10.1007/pl00022253.
Upper gastrointestinal bleeding, particularly from a stress-induced duodenal ulcer, is an extremely important perioperative complication in cardiovascular surgery.
In the present study, 33 patients undergoing elective open heart surgery between July 2000 and February 2001 were allocated to either a famotidine (FAM) or rabeprazole (RPZ) group to examine the perioperative gastric and esophageal pH readings, in conjunction with an investigation into the effect of infection with Helicobacter pylori (HP).
Postoperative upper gastrointestinal bleeding did not occur in either group, and the intraoperative and postoperative mean gastric pH readings, as well as the holding time pH>6, suggested sufficient acid suppression by either drug. Gastric acid secretion was less strongly suppressed in HP-negative patients in the FAM group, but was unaffected by HP infection status in the RPZ group.
The FAM group and RPZ group revealed a sufficient effect of gastric acid suppression. It was indicated that FAM had an insufficient effect of gastric acid suppression for HP-negative patients.
上消化道出血，尤其是应激性十二指肠溃疡引起的出血，是心血管外科手术中极为重要的围手术期并发症。
在本研究中，2000年7月至2001年2月期间接受择期心脏直视手术的33例患者被分为法莫替丁（FAM）组或雷贝拉唑（RPZ）组，以检测围手术期胃和食管的pH值读数，并调查幽门螺杆菌（HP）感染的影响。
两组均未发生术后上消化道出血，术中及术后平均胃pH值读数以及pH>6的持续时间表明两种药物均能充分抑制胃酸。FAM组中HP阴性患者的胃酸分泌抑制作用较弱，但RPZ组中胃酸分泌不受HP感染状态的影响。
FAM组和RPZ组均显示出充分的胃酸抑制效果。结果表明，FAM对HP阴性患者的胃酸抑制作用不足。
