乳果糖预防消化道出血后诱发肝性脑病的疗效观察

Curative effect of lactulose on prevention of hepatic encephalopathy induced by gastrointestinal hemorrhage

目的探讨乳果糖预防肝硬化患者上消化道出血后诱发肝性脑病的疗效。方法收集我科因乙肝肝硬化、丙肝肝硬化及其他原因导致的肝硬化出现消化道出血患者42例,随机分为观察组(n=22)和对照组(n=20)。观察组在无活动性出血后在常规治疗基础上加用乳果糖口服,对照组除不用乳果糖外,其他治疗与观察组相同。1周后观察临床症状,数字连接试验(NCT),血氨等变化以判断疗效。结果观察组2例发生肝性脑病,发生率为9.1%;对照组8例发生肝性脑病,发生率为40%(χ2=3.9450,P<0.05)。两组治疗前血氨含量、NCT检测结果相似,治疗后对照组血氨含量上升、NCT延长的程度明显大于观察组。结论乳果糖是预防肝硬化患者上消化道出血诱发肝性脑病的有效方法。

Objective To explore the curative effect of lactulose on prevention of hepatic encephalopathy induced by upper gastrointestinal hemorrhage.Methods Forty-two blood samples were collected from cirrhosis caused by hepatitis B,C or other disease.They were randomly divided into two groups.The testing group included 22 patients and the control group included 20 patients.The testing group started to administer lactulose when the symptoms of active bleeding disappeared.The control group experienced the same treatment except lactulose.The effect was evaluated one week after lactulose administration.The testing item included clinical symptoms,intelligence test,number connection test（NCT） and the blood ammonia determination.Results Hepatic encephalopathy happened in two patients in the testing group（9.1%） and eight patients in the control groups（40%）（χ^2=3.9450,P〈0.05）.The blood ammonia content and NCT of the patients in two groups were similar before treatment.After treatment,the blood ammonia content of the patients increased in the control group（t=2.741,P〈0.05）.And the extension degree of NCT in testing group was obviously lower than that in the control group（t= 2.133,P〈0.05）.Conclusion Lactulose treatment is a effective method for preventing hepatic encephalopathy induced by upper gastrointestinal hemorrhage.