乳果糖灌肠联合门冬氨酸鸟氨酸治疗昏迷期肝性脑病的临床疗效及安全性评价Effects and Adverse Reactions of Retention Enema of Lactulose and Ornithine Aspartate in Treatment of the Hepatic Encephalopathy Patients in Coma Stage
罗国彪,杨绮红,黄素军,冯素玲
LUO Guobiao,YANG Qihong,HUANG Sujun,FENG Suling
摘要(Abstract)：
目的分析乳果糖保留灌肠联合门冬氨酸鸟氨酸治疗昏迷期(Ⅳ期)肝性脑病的临床疗效及安全性。方法 40例肝硬化合并昏迷期肝性脑病患者随机分为治疗组和对照组,每组20例,在基础治疗上,两组均用门冬氨酸鸟氨酸10 g,每天2次,静脉滴注,乳果糖15 mL/次,口服,每天3次。治疗组在上述治疗的基础上加用乳果糖保留灌肠60 mL/次,每天2次,比较两组患者治疗前后的症状、清醒时间、肝功能、血氨变化及总有效率,并观察其不良反应。结果治疗组清醒时间为(1.6±1.0)d,血氨下降至(55.44±20.24)mmol·L~(-1),对照组清醒时间为(2.5±1.2)d,血氨下降至(75.35±31.12)mmol·L~(-1),与对照组比较,治疗组可明显改善患者症状、缩短患者清醒时间,降低血氨水平,提高总有效率,降低不良反应发生率,差异有统计学意义(P<0.05)。结论乳果糖保留灌肠联合门冬氨酸鸟氨酸治疗昏迷期肝性脑病的疗效确切,安全性较好。
OBJECTIVE To analyze effects and adverse reactions of retention enema of lactulose and ornithine aspartate in treatment of the hepatic encephalopathy patients in coma stage. METHODS 40 hepatic encephalopathy patients in coma stage were divided into treatment group and control group randomly with 20 patients in each group. The patients in both groups were treated by lactulose and ornithine aspartate and those in treatment group were treated with the retention enema of lactulose. The symptoms,waking time,liver function,blood ammonia changes and the total effective rate of the two groups before and after the treatment were compared,and adverse reactions were observed. RESULTS The waking time of the treatment group was( 1. 6 ± 1. 0) days,the level of blood ammonia of the treatment group was( 55.44±20.24) mmol·L~(-1),the waking time of the control group was( 2.5±1.2) days,the level of blood ammonia of the treatment group was( 75. 35 ± 31. 12) mmol·L~(-1),compared with the contronl group,the treatment group could significantly improve the symptoms of patients,shorten the waking time,reduce the level of blood ammonia,improve the total effective rate,the difference was significant( P<0.05). CONCLUSION Retention enema of lactulose and ornithine aspartate in treatment of the hepatic encephalopathy patients in coma stage is effective and safety.
关键词(KeyWords)：
肝性脑病;门冬氨酸鸟氨酸;乳果糖;保留灌肠
hepatic encephalopathy;ornithine aspartate;lactulose;retention enema
基金项目(Foundation):
作者(Author):
罗国彪,杨绮红,黄素军,冯素玲
LUO Guobiao,YANG Qihong,HUANG Sujun,FENG Suling
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