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许多严重应激的病人可发生上段胃肠道粘膜损害,这些病人主要损害是发生于胃底和胃体的多发性糜烂和粘膜下出血,偶可发生在十二指肠和食道,常见于严重创伤、烧伤、败血症、大手术、休克和多系统器官衰竭。本文旨在评价24小时内严重颅脑损伤患者“应激性胃炎”的表现、分布及发病率。病人入院时格拉斯哥昏迷计分(GCS)10分或以下,需通气支持。受伤后24小时内和在应激性胃炎特异性保护性治疗前做上段胃肠道内窥镜(EGD)检查,以估价食道、胃和十二指肠粘膜损害及其分布情况。损害程度分为:0度:粘膜正常;Ⅰ度:粘膜糜烂或粘膜下出血1～5处;Ⅱ度:粘膜糜烂或粘膜下出血6～20处;Ⅲ度:粘膜糜烂或粘膜下出血超过20处。颈椎骨折、胃损伤或已用类固醇患者除外。
Many serious stress patients may occur in the upper gastrointestinal mucosal damage, these patients mainly occur in the gastric and gastric mucosal bleeding occurred in multiple erosion and submucosal bleeding, even in the duodenum and esophagus may occur, common in severe Trauma, burns, sepsis, major surgery, shock and multiple system organ failure. This article aims to evaluate the performance, distribution, and incidence of “stress gastritis” in patients with severe craniocerebral injury over a 24-hour period. Patients admitted to hospital with a Glasgow coma score of 10 points or less need ventilatory support. Upper gastrointestinal endoscopy (EGD) was performed within 24 hours after injury and prior to specific protective treatment for stress gastritis to assess lesions and their distribution in the esophagus, stomach and duodenum. The degree of damage is divided into: 0 degrees: mucosal normal; Ⅰ degree: mucosal erosion or submucosal bleeding 1 to 5; Ⅱ degree: mucosal erosion or submucosal bleeding 6 to 20; Ⅲ degree: mucosal erosion or submucosal bleeding more than 20 Department. Cervical spondylosis, stomach damage or steroids other than patients.