大黄加芒硝对危重病患者 胃肠功能障碍的疗效观察

Clinical effect of rhubarb combined with sodium sulfate on gastrointestinal dysfunction in critical care patients

关键词:  大黄  芒硝  危重病患者  胃肠功能

Key words:  rhubarb  sodium sulfate  critical care patient  gastrointestinal function

摘要:

[目的] 探讨大黄加芒硝对危重病患者胃肠功能保护和治疗作用。[方法] 纳入研究的患者均满足消化功能障碍和慢性健康状况评分系统(APACHEⅡ)≥16分并排除有器质性胃肠疾病的患者。治疗组:用生大黄50 g,开水100 mL浸泡15 min至深褐色, 经胃管缓慢鼻饲, 每8 h 1次, 外用芒硝100 g,双层敷料包裹, 平敷于肚脐处, 待纱布袋潮湿后及时更换, 每日更换2~3次;对照组:枸橼酸莫沙必利片10 mg,鼻饲, 每8 h 1次。观察两组腹胀缓解时间、开始排便时间、肠内营养开始时间及消化道出血的发生率。[结果] 治疗组在腹胀缓解的时间, 顺利开始给予肠内营养的时间及开始排便时间均短于对照组, P<0.05或P<0.01.消化道出血发生率, 治疗组显着低于对照组。[结论] 大黄加芒硝能明显保护危重病患者胃肠功能, 减少消化道出血的发生率, 明显改善患者的预后。

Abstract:

[Objective] To observe the protective and treatment effects of rhubarb combined with sodium sulfate in critical care patients with gastrointestinal dysfunction. [Methods] The enrolled patients in the study had digestive disorders and APACHE Ⅱ≥16 scores and the patients with organic gastrointestinal diseases were excluded. In treatment group: the 50 mg of crude rhubarb was inserted in 100 mL of water at 100℃ for 15 minutes till dark brown was found. After that the drug was infused into the treatment patients by stomach tube feeding slowly, 3 times a day. At the same time 100 g of sodium sulfate in double dressing package was flatly masked on belly button, changed a time when the gauze bag became wet and changed 2~3 times a day. In control group: 10 mg of mosanpride tablets was given by nasal feeding, 3 times a day. The time of abdominal distension relieving, time of beginning to defecate, time of starting enteral nutrition and the incidence of gastrointestinal bleeding were observed in both groups. [Results] In treatment group the time of abdominal distension relieving, the time of smoothly starting enteral nutrition and defecate time were shorter than that in control group (P<0.05 or P<0.01). Incidence of gastrointestinal bleeding in treatment group was also significantly lower than that in control group. [Conclusion] Rhubarb combined with sodium sulfate can significantly protect the patients with gastrointestinal dysfunction in critical care, reduce the incidence of gastrointestinal bleeding and ameliorate the prognosis of patients.