乳果糖预防口服吗啡所致便秘的疗效观察  

Clinical observation of prophylactic lactulose for prevention of oral morphine-induced constipation

作　　者：王湛 钱建新[1] 焦晓栋[1] 原凌燕[1] 肖呜[1] 顾小强[1] 娄成[1] 王妙苗[1] 蓝海峰[1] 

机构地区：[1]第二军医大学附属长征医院肿瘤科,上海200070

出　　处：《中华医学杂志》2012年第42期2968-2971,共4页National Medical Journal of China

摘　　要：目的评价不同剂量乳果糖对口服吗啡制剂所致便秘的疗效。方法回顾性分析上海长征医院肿瘤科2011年1月至2012年5月使用乳果糖口服溶液预防口服吗啡所致便秘患者的临床资料，共有112例口服吗啡的患者入组，其中男52例，女60例，按其乳果糖服用剂量不同分为3组，分别接受30、60、90ml每Et顿服乳果糖口服液给药，分别为40、43、29例。吗啡为口服给药，并根据疼痛评分调整剂量，其与乳果糖同时使用。分析患者用药后1周便秘和不良反应的发生率。对于计量数据采用方差分析，计数数据采用妒、Kruskal-Wallis和Mann—WhitneyU检验。结果乳果糖30、60、90ml组便秘发生率分别为67．5％（27／40）、46．5％（20／43）和37．9％（11／29），差异有统计学意义（P110．036）。30ml和60ml组、60ml和90ml组差异均无统计学意义（P=0．054、0．471），30ml组明显高于90m1组（P=0．015）。90ml组呕吐发生率均高于30和60ml组[34．5％（10／29）比10．0％（4／40）和9．3％（4／43），P=0．013和0．009]，后两组差异无统计学意义（P=0．915）。90m1腹泻发生率明显高于30ml组[17．2％（5／29）比0，P=0．007]，与60ml组[4．7％（2／43）]差异无统计学意义（P=0．072），60与30ml组比较差异亦无统计学意义（P：0．170）。结论60ml／d的乳果糖口服溶液是预防性吗啡所致便秘较为合适的剂量。Objective To evaluate the effects of different doses of lactulose on preventing oral morphine-induced constipation. Methods From January 2011 to May 2012, a total of 112 patients received oral lactulose solution to prevent morphine-induced constipation at our hospital and their clinical data were retrospectively analyzed. The doses of morphine were adjusted according to the pain scores and lactulose was taken simultaneously. There were 52 males and 60 females. They were randomized into Group 30 ml/d （ n = 40）, Group 60 ml/d （ n = 43 ） and Group 90 ml/d （ n = 29 ） . The incidences of constipation and adverse reactions were obtained at 1 week after the start of medicine. The measurement data were analyzed with analysis of variance. And the enumeration data were analyzed with X2 , Kruskal-Wallis and Mann-Whitney U tests. Results The incidence of constipation was 67.5% （27/40） in Group 30 ml/d, 46. 5% （20/43） in Group 60 ml/d, and 37.9 % （ 11/29 ） in Group 90 ml/d. And there were statistical differences （ P = 0. 036 ）. The incidence of constipation in Group 30 ml was significantly higher than Group 90 ml/d（P = 0. 015）. No statistical difference existed in the incidence of constipation between Groups 30 ml/d and 60 ml/d （P = 0. 054） or Groups 60 ml/d and 90 ml/d （P = 0. 471 ）. The incidence of vomiting was 34. 5% （10/29） in Group 90 ml/d and it was significantly higher than 10. 0% （ 4/40 ） in Group 30 ml/d （ P = 0. 013 ） and 9. 3% （4/43） in Group 60 ml/d （P = 0. 009）. No statistical difference existed in the incidence of vomiting between Groups 30 ml/d and 60 ml/d （P =0. 915）. The incidence of diarrhea was 17.2% （5/29） in Group 90 ml/d and it was significantly higher than 0 （0/40） in Group 30 ml/d （ P = 0. 007 ）. No statistical difference existed in the incidence of diarrhea between Groups 30 ml/d and 60 ml/d （4. 7% （2/43）, P = 0. 170） or Groups 60 ml/d and 90 ml/d （P =0. 072）. Conclusion The correct dosage of lactulose for the ore

关 键 词：乳果糖 吗啡 便秘 

分 类 号：R595.3[医药卫生—内科学]