乳果糖灌肠对梗阻性黄疸术后早期血清内毒素和肝功能的影响

The Effect of Lactulose Enema on endotoxin and Liver Function for the Patients with Obstructive Jaundice in the perioperative Period

目的：探讨乳果糖灌肠对梗阻性黄疸术后早期血清内毒素和肝功能的影响。方法选择2009年8月～2013年8月我科因急性结石性胆道梗阻行手术治疗病人120例，随机分为乳果糖灌肠组和对照组，各60例。乳果糖灌肠组采用乳果糖口服液60ml＋0．9％氯化钠液60ml保留灌肠。对照组采用0．9％氯化钠液120ml保留灌肠。动态评估术后血清内毒素和肝功能的变化情况。结果术前及术后第1d两组血清内毒素水平和肝功能各项指标比较无显著性差异（P＞0．05）；乳果糖灌肠组血清内毒素水平术后第3d和第5d明显低于对照组，有显著性差异（P＜0．05）；乳果糖灌肠组血清内毒素水平第3d起明显低于入院时水平（P＜0．05）；对照组血清内毒素水平第5d起低于入院时水平（P＜0．05）。乳果糖灌肠组肝功能各项指标改善显著优于对照组（P＜0．05）。结论乳果糖灌肠可降低梗阻性黄疸术后早期血清内毒素水平，并明显改善肝功能。

Objective To study the effect of Lactulose enema on endotoxin and liver function for the patients with obstructive jaundice in the perioperative period .Methods One hundred and twenty patients with obstructive jaundice prepared for operation w ere randomly divided into Lactulose enema group A（=60）and control group B（n = 60） .All the＆amp;nbsp;patients received the same conventional therapy .Then dynamic observation of liver function and endotoxin level .This trial is registered in the Chinese Clinical Trial Register （ChiCTR-TRC -12002517） .Results The endotoxin levels and liver func-tion between the two groups showed no significant difference in preoperative and postoperative 1st day .But after postopera-tive 2nd day ,the endotoxin levels of group A were Significantly lower than the control group ,which showed a significant difference （P＆lt;0 .05） .And the indicators of liver function in group A decreased more obviously than those of group B after operation（P＆lt;0 .05） .Conclusion Lactulose enema may decrease the serum endotoxin levels and improve liver function for the patients with obstructive jaundice in the perioperative period .