摘要
目的探讨食用白醋保留灌肠治疗肝性脑病的有效浓度,为统一临床治疗标准提供循证依据。方法对2017年1月至2018年8月在我院消化内科住院的112例肝性脑病患者采用随机数字表法将其分为试验组49例和对照组63例。在其他治疗方法一致的情况下,试验组和对照组分别采用等渗性灌肠液(食醋35mL+生理盐水100mL)和经验性灌肠液(食醋30mL+生理盐水100mL)进行保留灌肠。分别于灌肠前、灌肠后1天和灌肠后2天观察两组患者神志恢复情况、静脉血氨和血pH的变化。结果两组不同时间测得血氨值组间比较差异无统计学意义(F=0.243,P=0.625),两组不同时间静脉血pH组间比较差异也无统计学意义(F=0.007,P=0.932)。组内比较发现不同时间患者的血氨水平差异均有统计学意义(F=7.861,P=0.000),试验组患者的血氨浓度呈逐渐下降趋势,而对照组患者的血氨浓度灌肠后一天下降而灌肠后第二天又小幅度回升;不同时间患者的静脉血pH值之间差异有统计学意义(F=4.319,P=0.021),两组患者静脉血pH值均呈逐渐下降趋势。结论采用等渗性的食用白醋灌肠液治疗肝性脑病有效,安全性较高,值得临床推广应用。
Objective To investigate the effective concentration of white vinegar retention enema in the treatment of hepatic encephalopathy,and to provide evidence-based basis for unified clinical treatment standards.Methods From January 2017 to August 2018,112 patients with hepatic encephalopathy who were hospitalized in the Department of Gastroenterology of our hospital were divided into experimental group(49 cases)and control group(63 cases)by random number table method.The experimental group used isotonic enemas(35mL vinegar+normal saline 100mL),while the control group used empirical enemas(30mL vinegar+normal saline 100mL)for retention enemas,at the same time,other treatments remained consistent.The consciousness recovery,venous blood ammonia changes and blood pH were compared before enema,1 day after enema and 2 days after enema.Results There was no statistically significant difference between two groups of blood ammonia measured at different times(F=0.243,P=0.625),and the blood pH at different times also had no statistically significant difference(F=0.007,P=0.932).Comparison within groups found that the differences in blood ammonia levels at different times were statistically significant(F=7.861,P=0.000).The blood ammonia concentration of experimental group gradually decreased,while the blood ammonia concentration of control group fell after enema one day,then rose slightly after enema second day;the venous blood pH at different times was statistically significant(F=4.319,P=0.021),and the blood pH of both groups gradually decreased.Conclusion It would be effective and safe to treat hepatic encephalopathy with isotonic edible white vinegar enema,which is worthy of clinical application.
作者
任宏飞
刘常清
魏明芳
申明
李杨玲
夏迪
严娅
王瑞
张铭光
Ren Hongfei;Liu Changqing;Wei Mingfang(Department of Gastroenterology,Anaesthesia Surgery Center,West China Hospital,Sichuan University,Chengdu,Sichuan 610041,China)
出处
《四川医学》
CAS
2020年第1期38-42,共5页
Sichuan Medical Journal
基金
四川省卫生和计划生育委员会课题(编号:17PJ3rr)
关键词
肝性脑病
食用白醋
保留灌肠
浓度
hepatic encephalopathy
white vinegar
retention enema
concentration
