论文部分内容阅读
目的评估纳洛酮乳果糖治疗肝硬化轻微肝性脑病(MHE)的疗效。方法 60例MHE随机分为治疗A组、治疗B组及对照组各20例,各组之间在年龄、性别、病程、肝功能child-Pugh分级、文化程度等方面均有可比性,P>0.05差异无统计学意义。治疗A组应用0.9%氯化钠注射液250ml+纳洛酮针0.8mg,1次/d静脉滴注;治疗B组乳果糖口服液15～30ml/次,3次/d口服;对照组应用0.9%氯化钠注射液250ml,1次/d静脉滴注;连用14d。用药前后分别行数字连接试验(NCT),数字符号试验(DS)检测及测定血氨,并随访是否发生显性肝性脑病(OHE)。结果治疗A组、治疗B组治疗后NCT、DS均比治疗前明显改善,P<0.01且无1例发展为OHE。治疗A组与治疗B组治疗后相比,P>0.05差异无统计学意义,疗效相当。不良反应轻微。对照组治疗前后NCT、DS无变化,发生显性肝性脑病(OHE)3例。结论纳洛酮、乳果糖治疗轻微肝性脑病疗效肯定且相当、安全、不良反应少,值得临床推广应用。
Objective To evaluate the efficacy of naloxone lactulose in the treatment of cirrhosis with mild hepatic encephalopathy (MHE). Methods 60 cases of MHE were randomly divided into treatment group A, treatment group B and control group, 20 cases in each group in age, sex, duration of liver function child-Pugh grading, educational level and other aspects are comparable, P> 0.05 difference was not statistically significant. Treatment group A 0.9% sodium chloride injection 250ml + naloxone needle 0.8mg, 1 / d intravenous infusion; group B lactulose oral solution 15 ~ 30ml / times, 3 times / d orally; control group 0.9 % Sodium chloride injection 250ml, 1 / d intravenous infusion; once every 14d. Before and after treatment, digital connection test (NCT), digital sign test (DS) were used to detect and measure blood ammonia, followed by the occurrence of overt hepatic encephalopathy (OHE). Results After treatment, the NCT and DS in treatment group A and treatment group B were significantly improved compared with that before treatment, P <0.01 and no one developed OHE. Treatment A group and treatment group B after treatment, P> 0.05 difference was not statistically significant, the effect is quite. Minor adverse reactions. The control group before and after NCT, DS no change, the occurrence of overt hepatic encephalopathy (OHE) in 3 cases. Conclusion Naloxone and lactulose are effective and safe in the treatment of mild hepatic encephalopathy. They are worthy of clinical application.