Changes of intramucosal pH(pHi) after severe craniocerebral injuries and the correlation to bleeding from stress ulceration / 医学研究生学报

Objective:To determine the changes of intramucosal pH(pHi) after severe craniocerebral injuries and the correlation to bleeding from stress ulceration. Methods:Nineteen cases of severe head trauma patients were enrolled, their pHi were determined at different time point with tonometry. The pH of gastric juice and plasma gastrin concentrations were monitored for 7 days. Results:Five cases(bleeding group) developed stress ulcer bleeding. On admission, the pHi were not significantly different in the non bleeding group, but the differences between two groups at 12 hours, 24 hours, the 3rd day, the 5th day, the 7th day after admission were significant, pHi in the bleeding group was statistically lower than non bleeding group. The pH values of gastric juice and the plasma gastrin concentrations were not different significantly between two groups during each therapeutic periods. Conclusion:Bleeding group had significantly lower pHi than non bleeding group during the therapeutic periods. pHi was predictive for bleeding from stress ulceration after severe craniocerebral injury.

Massive Gastrointestinal Bleeding Following Intracranial Lesion

"Stress ulceration" of the stomach and duodenum is a nonspecific term used to cover a wide variety of different entities. It has been known for many years that there is an association between gastrointestinal bleeding and intracranial lesion. This is not a common clinical problem, but it has been noted to be increasing over the recent years, possibly due to the increased survival of severe injured neurosurgical patients and neurosurgical procedures. Clinically recongnition of gastrointestinal bleeding or ulceration can be difficult, partcularly in the unconscious patient and prevention of this complication has not been successful. The treatment of that has been the subject of considerable controversy. Prognosis depends on a prevention of hemorrhagic shock or sepsis and promptly proper management. The authors analyzed the 21 cases of massive gastrointestinal bleeding in neurosurgical patients, who were admitted to the department of neurosurgery of National Medical Center from 1978 to 1980.