摘要
目的:研究卡巴胆碱治疗创伤和感染后胃肠功能障碍的有效性和安全性.方法:选取2007-02/2008-02唐山市3家三级医院ICU重症患者140例,随机分为卡巴胆碱组(n=78)和莫沙比利组(n=62).观察患者治疗前(0h)、治疗后24,48,72h及7d的肠管积气、积液、胃肠功能评分、临床总有效率和血清二胺氧化酶(DAO)、D-乳酸和内毒素水平变化.结果:与莫沙比利组比较,治疗后卡巴胆碱组患者肠管积气/积液明显改善(P<0.05),第7天胃肠功能评分明显降低(P<0.05),临床总有效率显著提高(62.8%vs43.6%,P<0.05).血清DAO、D-乳酸和内毒素水平第7天均明显低于莫沙比利组(P<0.05).结论:卡巴胆碱可以降低创伤和感染重症患者血清DAO、D-乳酸和内毒素水平,改善肠积气,降低胃肠功能评分,具有胃肠功能保护作用.
AIM: To investigate the efficacy of carbachol in the treatment of gastrointestinal dysfunction induced by severe trauma or infection. METHODS: One hundred and forty intensive care unit (ICU) patients selecting from three hospitals in Tangshan City were randomly divided into two groups: carbachol treatment group (n = 78) and mosapride citrate treatment group (n = 62). Intestinal pneumatosis and hydrops, gastrointestinal dysfunction scores and overall response rate were observed. The activity of plasma diamine oxidase (DAO) and the content of serum D-lactic acid were determined at 0, 24, 48 and 72 hours and on day 7 after treatment, respectively. RESULTS: Compared to the mosapride citrate treatment group, patients in the carbachol treatment group showed a significant improvement in intestinal pneumatosis and hydrops (P 〈 0.05), a significant decrease in gastrointestinal dysfunction scores (P 〈 0.05), an obvious increase in overall response rate (43.6% vs 62.8%, P 〈 0.05), as well as a significant decline in the activity of DAO and the contents of serum D-lactic acid and endotoxin on day 7 after treatment (P 〈 0.05). CONCLUSION: Carbachol can decrease the activity of plasma DAO and the levels of serum D-lactic acid and endotoxin, and improve intestinal function in patients with severe trauma- or infection-induced gastrointestinal dysfunction.
出处
《世界华人消化杂志》
CAS
北大核心
2009年第20期2091-2095,共5页
World Chinese Journal of Digestology