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目的乳果糖辅助治疗肝硬化致消化道出血对预防肝性脑病的作用。方法 98例肝硬化致消化道出血患者,随机分为观察组和对照组,各49例。对照组患者给予单纯基础治疗,观察组患者在对照组基础上加用乳果糖。对比两组患者肝性脑病发生率、血氨含量、数字连接试验(NCT)检测结果。结果经治疗,观察组有2例发生肝性脑病,占4.08%,对照组有10例发生肝性脑病,占20.41%,比较差异具有统计学意义(χ2=3.9452,P<0.05)。观察组治疗前NCT(59.6±22.5)s,治疗后(43.8±9.1)s,对照组治疗前(59.3±20.1)s,治疗后(58.2±10.4)s,观察组治疗前血氨含量(56.4±18.6)μmol/L,治疗后(37.2±10.6)μmol/L,对照组治疗前(55.8±16.5)μmol/L,治疗后(51.2±18.5)μmol/L,两组治疗前对比差异无统计学意义(P>0.05),治疗后,观察组NCT、血氨含量改善情况优于对照组,差异有统计学意义(P<0.05)。结论在肝硬化致消化道出血中加用乳果糖能起到预防肝性脑病发生的作用,改善肝功能,降低病死率,提高患者生活质量,值得临床推广和应用。
Objective To investigate the effect of lactulose adjuvant therapy on hepatic encephalopathy in patients with cirrhosis-induced gastrointestinal bleeding. Methods A total of 98 patients with cirrhosis and gastrointestinal bleeding were randomly divided into observation group and control group, 49 cases in each group. Patients in the control group were treated with simple basal therapy. Patients in the observation group were given lactulose on the basis of the control group. The incidence of hepatic encephalopathy, blood ammonia level and NCT test results were compared between the two groups. Results After treatment, hepatic encephalopathy was found in 2 cases in the observation group and 4.08% in the observation group. Hepatic encephalopathy occurred in 10 cases in the control group, accounting for 20.41%. The difference was statistically significant (χ2 = 3.9452, P <0.05). The levels of ammonia (NH4 +) in the observation group before treatment (59.6 ± 22.5) s, after treatment (43.8 ± 9.1) s, before treatment (59.3 ± 20.1) s and after treatment ± 18.6μmol / L, 37.2 ± 10.6μmol / L after treatment, 55.8 ± 16.5μmol / L before treatment and 51.2 ± 18.5μmol / L after treatment, respectively (P> 0.05). After treatment, the improvement of blood ammonia level in NCT of the observation group was better than that of the control group (P <0.05). Conclusions Adding lactulose to cirrhosis-induced gastrointestinal hemorrhage can play a role in prevention of hepatic encephalopathy, improve liver function, reduce mortality and improve quality of life of patients. It is worthy of clinical promotion and application.