论文部分内容阅读
研究大黄对脓毒症并发应激性胃肠粘膜病变的治疗作用及其机制。43例ICU患者中脓毒症并发应激性胃肠粘膜病变22例（治疗组），非脓毒症恢复期患者21例（对照组）。检测胃和直肠粘膜内pH值（pHi）和血流动力学参数。结果：大黄止血有效率为81．8％，治疗前患者胃和直肠pHi分别为7．0180±0．1170和7．0710±0．1860，大黄治疗后胃和直肠pHi分别为7．3050±0．0950和7．2680±0．0785，均有非常显著性差异（P均＜0．01）；对照组胃pHi为7．3350±0．1800。血流动力学参数显示，治疗前尽管全身氧输送和心排指数远远高于正常，但胃和直肠pHi很低，即胃肠道仍处于严重灌注不足和缺氧状态。作者认为：大黄对应激性胃肠粘膜病变有明显治疗作用，其作用机制可能通过增加胃肠粘膜灌注、清除氧自由基和促进胃肠粘膜新陈代谢实现的。
To study the therapeutic effect of rhubarb on sepsis complicated by stressful gastrointestinal mucosal lesions and its mechanism. Forty-three ICU patients had sepsis complicated with stressful gastrointestinal mucosal lesions in 22 cases (treatment group) and non-sepsis recovery group in 21 cases (control group). Gastric and rectal mucosal pH (pHi) and hemodynamic parameters were measured. Results: The effective rate of rhubarb hemostasis was 81.8%. The gastric and rectal pHi before treatment were 7.0180±0.1170 and 7.0710±0.1860, respectively. The gastric and rectal pHi after rhubarb treatment was 7.3050±. Both 0.0950 and 7.2680±0.0785 were significantly different (P<0.01). In the control group, gastric pHi was 7.3350±0.1800. Hemodynamic parameters showed that although the systemic oxygen delivery and cardiac output index were much higher than normal before treatment, the gastric and rectal pHi was very low, ie, the gastrointestinal tract was still under severe hypoperfusion and hypoxia. The authors believe that: rhubarb has a significant therapeutic effect on stress gastrointestinal mucosal lesions, its mechanism may be achieved by increasing gastrointestinal mucosal perfusion, scavenging oxygen free radicals and promoting gastrointestinal mucosal metabolism.