鼻饲大黄治疗烧伤休克患者并胃肠功能障碍的临床疗效

Clinical efficacy of nasogastrically administered rhubarb for gastrointestinal dysfunction after burn shock

目的:探讨大黄在治疗烧伤休克患者并胃肠功能障碍中的临床效果.方法:采用前瞻性、完全随机对照的研究方法,将83例因烧伤引起的休克并胃肠功能障碍患者作为研究对象,采用随机对照法将研究对象分为观察组42例和对照组41例,根据"应激性胃肠黏膜出血缓解标准"及"胃肠麻痹缓解标准"计算各组总有效率,记录各组病例潜血试验转阴所需天数、胃肠功能障碍持续时间,监测氧合指数(oxygenation index,PaO_2/FiO_2),血肌酐(serum creatinine,SCr)、血清尿素氮(blood urea nitrogen,BUN),谷丙转氨酶(alanine transaminase,ALT)、谷草转氨酶(aspartate aminotransferase,AST),免疫球蛋白(immunoglobulin,Ig)A、IgG、IgM水平变化情况,对上述所得结果进行统计学分析.结果:观察组患者治疗有效率显著高于对照组(88.10%vs 48.78%)(P<0.05);胃肠功能障碍持续时间及潜血试验转阴时间显著短于对照组(1.16d±0.56 d vs 3.48d±0.77 d,3.894 d±0.857 d vs 4.617 d±1.112d,P<0.05).观察组患者干预后PaO_2/FiO_2,SCr、BUN、ALT、AST、IgM水平均优于干预前(P<0.05);对照组患者干预后SCr、BUN、IgM水平均优于干预前(P<0.05);观察组患者干预后PaO_2/FiO_2,SCr,BUN,ALT及AST水平均优于对照组(P<0.05).结论:观察组加用大黄潜血试验转阴所需天数、胃肠功能障碍持续时间差异具有统计学意义,提示大黄具有一定的保护胃黏膜、促进胃肠蠕动的功能,对治疗烧伤休克并胃肠功能障碍的临床效果显著,应用价值较高.

AIM：To evaluate the therapeutic effects of rhubarb on gastrointestinal dysfunction after burn shock.METHODS：This was a prospective,randomized,controlled study.Eighty-three patients with gastrointestinal dysfunction after burn shock were randomly divided into either an observation group（42 cases） or a control group（41 cases）.The effective rate,duration of gastrointestinal dysfunction,days required for achieving negative occult blood（OB） test,oxygenation index（PaO2/FiO2）,alanine transaminase（ALT）,aspartate amino transferase（AST）,immunoglobulin（Ig） A,IgG,and IgM were compared for the two groups.RESULTS：The effective rate for the observation group was significantly higher than that for the control group（88.10%us 48.78%,P〈0.05）.The duration of gastrointestinal dysfunction and days required for achieving negative OB test were significantly lower in the observation group than in the control group（1.16 d ±0.56 d us 3.48 d ＋0.77 d,3.894d±0.857 d us4.617d± 1.112 d,P〈0.05）.The levels of PaO2/FiO2,serum creatinine（SCr）,blood urea nitrogen（BUN）,ALT,AST,and IgM for the observation group were better after intervention than before intervention（P〈0.05）.The levels of SCr,BUN,and IgM for the control group were better after intervention than before intervention（P〈0.05）.The levels of PaO2/FiO2,SCr,BUN,ALT,and AST after intervention were better in the observation group than in the control group（P〈0.05）.CONCLUSION：Treatment with rhubarb shortens the duration of gastrointestinal dysfunction and the days required for achieving negative OB test in patients with gastrointestinal dysfunction after burn shock,suggesting that rhubarb can protect the gastric mucosa and enhance gastrointestinal tract motility.