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目的 研究大黄对危重病患者MODS的防治效果。方法 10 90例ICU患者 ,研究对象的入选标准是严重创伤、休克、感染、外科急腹症、化学和物理因素损伤等所致脓毒症。 6 37例患者列入大黄预防治疗组 ,非大黄预防治疗组 4 5 3例。观察两组患者应激性溃疡、中毒性肠麻痹和MODS的发生率。结果 大黄预防组 6 37例患者中 ,并发应激性溃疡出血 5 7例 ,中毒性肠麻痹 4 3例 ,MODS 5 8例 ;而非大黄预防治疗组中 ,并发应激性溃疡出血 86例 ,中毒性肠麻痹 91例 ,MODS 95例 ,两组间有显著的统计学差异 (P<0 0 0 5 ) ;大黄预防组中 337例进行肠内营养 ,并发MODS 15例 ;而非大黄预防组中 178例进行肠内营养 ,并发MODS 2 3例 ,两组间有显著差异 (P <0 0 0 5 )。大黄预防组中肠内配合肠外营养 179例 ,并发MODS 10例、肠外营养 98例 ,并发MODS 15例 ;而非大黄预防组中肠内配合肠外营养 12 7例 ,并发MODS 19例、肠外营养 117例 ,并发MODS 32例 ,大黄预防组和非预防组间有显著差异 (P <0 0 5 )。肠外营养患者MODS的发生率高于肠内营养和肠内配合肠外营养的患者 (P <0 0 5 ) ;无营养支持的患者MODS的发生率最高。治疗研究显示累及四个以上脏器MODS患者中 ,伴胃肠功能衰竭患者经大黄治疗后其存活率达 5 2 6 % ,显著高于非
Objective To study the effect of rhubarb on the prevention and treatment of MODS in critically ill patients. METHODS: Totally 90 ICU patients were enrolled in the study. The inclusion criteria were severe trauma, shock, infection, surgical acute abdomen, and chemical and physical injury. Sixty-seven patients were enrolled in the rhubarb prevention group and non-rhubarb prevention group, 453 cases. The incidences of stress ulcer, toxic intestinal paralysis and MODS in both groups were observed. Results In rhubarb prevention group, 67 cases were complicated with stress ulcer bleeding, 43 cases of toxic intestinal paralysis and 58 cases of MODS. In non-rhubarb prevention group, there were 86 cases of stress ulcer bleeding, There were 91 cases of toxic enteric paralysis and 95 cases of MODS. There was significant difference between the two groups (P <0 05). In the rhubarb prevention group, 337 cases were enterally enrolled and 15 cases were complicated with MODS. Of the 178 patients enrolled in enteral nutrition, complicated by MODS 2 cases, there was a significant difference between the two groups (P <0 0 0 5). Rhubarb prevention group with 179 cases of parenteral nutrition in the intestine, complicated by MODS in 10 cases, 98 cases of parenteral nutrition, MODS complicated by 15 cases; non-rhubarb prevention group with parenteral nutrition in 127 cases, MODS in 19 cases, There were 117 cases of parenteral nutrition and 32 cases complicated with MODS. There was significant difference between rhubarb prevention group and non-prevention group (P <0.05). The incidence of MODS in patients with parenteral nutrition was higher than that in enteral nutrition and enteral parenteral nutrition (P <0.05). Patients without nutritional support had the highest incidence of MODS. Treatment studies have shown that more than four organs involving MODS patients with gastrointestinal failure patients treated with rhubarb after the survival rate of 526%, significantly higher than non-