乳果糖与白醋稀释液灌肠辅助治疗早期肝昏迷的疗效观察  

Efficacy Observation of Enema Therapy of Lactulose and White Vinegar Diluted Solution in the Treatment of Early Hepatic Coma

作　　者：肖政[1] 尹雄章[2] 

机构地区：[1]华中科技大学同济医学院附属普爱医院急诊科,武汉430034 [2]华中科技大学同济医学院附属同济医院药学部,武汉430030

出　　处：《中国药房》2013年第4期340-342,共3页China Pharmacy

摘　　要：目的:观察乳果糖与白醋稀释液灌肠辅助治疗早期肝昏迷的疗效及安全性。方法:将2011年1月-12月华中科技大学同济医学院附属普爱医院100例早期肝昏迷患者随机均分为乳果糖稀释液组和白醋稀释液组。2组患者均常规采用护肝及抗肝昏迷治疗,在此基础上乳果糖稀释液组用乳果糖50ml和0.9%氯化钠溶液150ml配成200ml灌肠液灌肠;白醋稀释液组用白醋50ml和0.9%氯化钠溶液150ml配成200ml灌肠液灌肠。观察2组灌肠后开始排便时间、排便量、大便隐血转阴时间、血氨浓度变化以及不良反应。结果:乳果糖稀释液组患者开始排便时间为灌肠后10～30min(平均17.5min),排便量较多,大便隐血转阴时间为(4.00±0.65)d,治疗后血氨浓度较治疗前显著降低(P<0.01),总有效率92.0%;白醋稀释液组患者开始排便时间为灌肠后5～10min(平均7min),排便量较少,大便隐血转阴时间为(7.30±1.42)d,治疗后血氨浓度较治疗前无显著降低,总有效率82.0%。2组患者开始排便时间、排便量、大便隐血转阴时间、血氨浓度和总有效率比较差异均有统计学意义(P<0.05)。2组均未见不良反应发生。结论:乳果糖和白醋稀释液灌肠均是辅助治疗早期肝昏迷的安全、有效方法,但乳果糖的疗效优于白醋。OBJECTIVE：To observe the efficacy and safety of enema therapy of lactulose and white vinegar diluted solution on the early hepatic coma.METHODS：100 patients with early hepatic coma in our hospital during Jan.-Dec.in 2011 were randomly divided into lactulose diluted solution group（n=50）and white vinegar diluted solution group（n=50）.2 groups received hepatoprotective and anti-hepatic coma treatment.Lactulose diluted solution group was additionally treated with 200 ml enema prepared by lactulose 50 ml and 0.9% sodium chloride 150 ml.White vinegar diluted solution group was additionally treated with 200 ml enema prepared by white vinegar 50 ml and 0.9% sodium chloride 150 ml.The beginning of defecation,the amount of defecation,the negative time of fecal occult blood,the concentration of blood ammonia and adverse drug reactions were observed in 2 groups.RESULTS：The beginning of defecation in lactulose diluted solution group was 10-30 min（17.5 min in average）and 5-10 min in white vinegar diluted solution group（7 min in average）.The amount of defecation in lactulose diluted solution group was more than in white vinegar diluted solution group.The negative time of fecal occult blood in lactulose diluted solution group and white vinegar diluted solution group were（4.00±0.65）days and（7.30±1.42）d,respectively.After treatment,the concentrations of blood ammonia were significantly decreased in lactulose diluted solution group（P0.01）,but no significant change in white vinegar diluted solution group.Total effective rates of them were 92.0% and 82.0%,respectively.There was a significant difference between them（P0.05）.There were statistical significance in above parameters of 2 groups（P0.05）.No adverse drug reaction was found in 2 groups.CONCLUSION：Both lactulose and white vinegar enema are safe and effective therapy for early hepatic coma.The efficacy of lactulose is better than that of white vinegar.

关 键 词：早期肝昏迷 乳果糖 白醋 稀释液 灌肠 疗效 安全性 

分 类 号：R575.2[医药卫生—消化系统]