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目的探讨乳果糖联合微生态制剂预防肝硬化上消化道出血后肝性脑病(HE)的疗效。方法 2012年1月至2016年1月住院的102例确诊肝硬化合并上消化道出血的患者,随机分为3组,包括乳果糖联合微生态制剂组(A组)、乳果糖组(B组)、对照组(C组),每组各34例。对照组采用常规综合治疗,乳果糖组在常规综合治疗的基础上加用乳果糖口服,乳果糖联合微生态制剂组在常规治疗的基础上加用乳果糖及微生态制剂。4周后观察三组HE的患病率及血氨水平。结果治疗后三组间HE发生率按C组(58.1%)、B组(26.7%)、A组(12.5%)组的顺序依次降低,差异有统计学意义(P<0.01),以A组最低且无昏睡期及昏迷期患者。三组间血氨水平按C组(48.20±1.53)μmol/L、B组(44.10±1.22)μmol/L、A组(33.18±3.32)μmol/L的顺序依次降低(P<0.01),以A组最低。结论乳果糖联合微生态制剂能预防HE的发生,两者联合应用优于单用乳果糖。
Objective To investigate the efficacy of lactulose combined with probiotics in preventing hepatic encephalopathy (HE) after cirrhosis and upper gastrointestinal bleeding. Methods A total of 102 hospitalized patients with cirrhosis and upper gastrointestinal bleeding hospitalized from January 2012 to January 2016 were randomly divided into three groups, including lactulose combined with probiotics (group A), lactulose group (group B ), Control group (C group), 34 cases in each group. The control group was treated with conventional therapy. The lactulose group was treated with lactulose orally on the basis of conventional comprehensive treatment. The lactulose combined with probiotics group was given lactulose and probiotics on the basis of routine treatment. After 4 weeks, the morbidity and blood ammonia level of HE in three groups were observed. Results The incidence of HE in the three groups after treatment was decreased in order of C group (58.1%), B group (26.7%) and A group (12.5%), the difference was statistically significant (P <0.01) The lowest and no sleeping and coma patients. The levels of ammonia in the three groups were decreased in the order of C group (48.20 ± 1.53) μmol / L, B group (44.10 ± 1.22) μmol / L and A group (33.18 ± 3.32) μmol / L Group A lowest. Conclusion lactulose combined with probiotics can prevent the occurrence of HE, the combination of both is better than lactulose alone.