腹安灌肠液治疗危重症患儿胃肠功能障碍的临床观察

Clinical Observation on Treatment of Gastrointestinal Dysfunction by Fu′an Liquid for Retention Enema in Children with Critical Illness

目的 :观察腹安灌肠液治疗危重症患儿胃肠功能障碍的疗效。方法 :将 89例危重症患儿随机分为西药常规治疗组 (简称对照组 )和西药常规加腹安灌肠液治疗组 (简称治疗组 ) ,分别于入院时、伴发胃肠功能障碍时及治疗后检测血浆内皮素 (ET)变化 ,并与健康对照组比较 ,同时观察患儿胃肠功能恢复情况和临床疗效。结果 :治疗组对胃肠功能障碍总有效率为 84 6 2 % ,与对照组 (6 2 17% )比较差异有显著性 (P<0 0 5 )。治疗组 5 2例中抢救成功 34例 ,死亡 16例 ,放弃治疗 2例 ,病死率 30 77% ;对照组 37例中抢救成功 16例 ,死亡 18例 ,放弃治疗 3例 ,病死率 4 8 6 5 % ,治疗组病死率低于对照组 (χ2 =4 6 4,P <0 0 5 )。入院时两组血浆ET含量均高于健康对照组 (P <0 0 1) ,伴发胃肠功能障碍时血浆ET比入院时明显增高 (P <0 0 1) ,治疗后逐渐下降 ,治疗组较对照组下降明显 ,两组治疗后比较差异有显著性 (P <0 0 5 )。结论 :危重症患儿伴发胃肠功能障碍时血浆ET明显增高 ,腹安灌肠液能有效降低血浆ET水平 ,促进危重症患儿胃肠功能恢复 ,对提高危重症抢救成功率起到一定的作用。

To observe the therapeutic effect of Fu′an Liquid (FAL) for retention enema in treating gastrointestinal (GI) dysfunction of children with critical illness. Methods: Eighty nine patients were randomly divided into two groups, 52 in the treated group and 37 in the control group. Conventional therapy of western medicine was given to both groups and to the treated group FAL was given additionally. Plasma endothelin (ET) level was measured during admission, GI dysfunction occurrence and after treatment, and the therapeutic effect as well as the recovery of GI condition were observed. Results: The total effective rate of FAL in treating GI dysfunction was 84.62%, which was significantly higher than that in the control group (62.17%) (P<0 05). In the treated group, 34 cases were treated successfully, 16 died and the other 2 abandoned, the mortality rate being 30.77%, while in the control group, the corresponding numbers were 16, 18, 3 and 48.65%. The mortality rate in the treated group was lower than that in the control group (χ 2=4 64,P<0 05). Level of ET in both groups was higher than normal range during admission (P<0 01), it further increased when GI dysfunction occurred (P<0 01), and decreased when successfully treated, the decrease was quicker in the treated group than that in the control group (P<0 05). Conclusion: In children with critical illness, ET level would increase when the patient was complicated with GI dysfunction. FAL for retention enema could reduce the ET level effectively, promote the recovery of patients from GI dysfunction, so as to play a definite role in enhancing the successful rate of rescue.