鼻饲生大黄治疗高血压脑出血昏迷患者胃肠功能紊乱的效果分析

Effect analysis of nasal feeding raw rhubarb in the treatment of hypertensive cerebral hemorrhage coma patients with gastrointestinal dysfunction

目的探讨鼻饲生大黄治疗高血压脑出血昏迷患者胃肠功能紊乱的临床效果及安全性。方法选择2013年5月至2014年11月天津市第五中心医院脑外科收治的76例高血压脑出血昏迷胃肠功能紊乱患者,随机分为观察组(39例)与对照组(37例)。对照组患者给予50 ml温开水鼻饲,观察组患者给予生大黄粉温开水搅拌均匀后鼻饲,2次/日,连续治疗7天。鼻饲后夹闭胃管1小时。比较两组患者治疗后第3天及第7天腹胀、胃食管反流、消化道出血及胃液潴留发生情况。结果治疗后第3天及第7天,观察组患者腹胀发生率、腹胀持续时间、胃食管反流及上消化道出血发生率均明显低于对照组(P<0.05)。观察组患者治疗后胃液量少于对照组(P<0.05)。结论鼻饲生大黄治疗高血压脑出血昏迷患者胃肠功能紊乱,有利于胃肠功能早日恢复,可降低临床病死、病残率,值得推广应用。

Objective To discuss about the clinical effect and safety of nasal feeding raw rhubarb in the treatment of patients who are suffered from gastrointestinal dysfunction due to hypertensive cerebral hemorrhage coma. Method Chose 76 patients who were suffered from gastrointestinal dysfunction due to hypertensive cerebral hemorrhage coma admitted to thoracic surgery department from May 2013 to November 2014, and they were divided into observation group（39 cases） and control group（37 cases） randomly. Control group patients were administered with 50 ml warm water by nasal feeding, observation group patients were administered with raw rhubarb powders（0.15 g/time） and 50 ml warm water after uniform mixing by nasal feeding, 2 times/day, treated for 7 days continuously. Clip the stomach tube for 1 hour after nasal feeding. The conditions of abdominal distension, diarrhea, gastroesophageal reflux, hemorrhage of digestive tract and gastric juice retention amount at the 3rd day and the 7th day were compared between the two groups. Result The rate of abdominal distension, abdominal distension duration, hemorrhage of digestive tract and gastroesophageal reflux were obviously lower than control group（P〈0.05）, the gastric juice volume of observation group was significantly lower than control group（P〈0.05）. Conclusion Nasal feeding raw rhubarb is beneficial to the early recovery of patients who are suffered from gastrointestinal dysfunction due to hypertensive cerebral hemorrhage coma, which can greatly decrease the clinical case fatality rate and disability rate, so it deserves popularization and application.