家庭乳果糖灌肠及口服治疗对预防复发肝性脑病的疗效比较  

The comparison of preventive effect of lactulose on recurrent hepatic encephalopathy by vetention enema and oral in home cures

作　　者：林浩[1] 郑永平[1] 谢玲珠[1] 

机构地区：[1]广东省汕头市中心医院,515031

出　　处：《中国现代医药杂志》2015年第10期52-54,共3页Modern Medicine Journal of China

摘　　要：目的比较家庭乳果糖保留灌肠及口服治疗对预防再发肝性脑病的疗效。方法选择2013年1月~2014年12月确诊的肝硬化肝性脑病经治疗后出院患者70例,随机分为两组（口服组和灌肠组）。除基础治疗外,口服组加用乳果糖口服,灌肠组在家加用乳果糖保留灌肠。比较两组患者出院当天及出院1个月后返院复查时精神状态、血氨、数字连接试验及再次住院情况。结果 1灌肠组精神状态改变量平均秩次为26.62,口服组精神状态改变量平均秩次为37.69,灌肠组的良好精神状态维持情况优于口服组（P=0.001）;2口服组血氨水平改变量平均秩次为37.25,灌肠组血氨水平改变量平均秩次为27.12,灌肠组血氨下降程度明显大于口服组（P=0.03）;3两组数字连接试验所需时间改变程度及再入院情况差异无统计学意义。结论出院后进行家庭乳果糖灌肠,对于维持肝硬化肝性脑病患者的精神状态、改善血氨水平,效果优于乳果糖口服治疗。Objective To compare the preventive effect of lactulose on recurrent hepatic encephalopathy （HE） by vetention enema and oral in home cures. Methods 70 HE patients discharged from hospital after recovery in our hospital from Jan 2013 to Dec 2014 were randomly devided into two groups, the oral group and ventention enema group. Both groups were given the basic treatment after out-hospital, besides that, the oral group were given the lactulose by oral while the other group were given the lactulose by ventention enema. The treatment was lasted for one month and the mental state, blood ammonia, number connection test （NCT） and the state of rehospitalization were compared. Results The maintenance of mental state and the improvement degree of blood ammonia of ventention enema group were significantly better than those of the oral group （P= 0.001, P=0.03）. There were no significant differences in time change of NCT and rehospitalization between the two groups. Conclusion It is better for HE patients to take lactulose by vetention enema in home cures to maintain the mental state and improve blood ammonia than by oral.

关 键 词：肝性脑病 乳果糖 保留灌肠 

分 类 号：R575.3[医药卫生—消化系统]