丙泊酚在肝性脑病狂躁期中应用分析.docVIP

丙泊酚在肝性脑病狂躁期中的应用分析 　　[摘要] 目的 探讨丙泊酚在肝性脑病狂躁期中的临床疗效及不良反应。方法 方便选取2010 年 1 月―2016 年4 月福建医科大学附属三明第一医院消化内科和中山大学附属第一医院消化科 40 例临床表现为狂躁的肝性脑病住院患者，随机分成2组，在饮食控制和内科药物治疗基础上，观察组20例给予丙泊酚，初始静脉推注丙泊酚 100 mg，继而根据患者狂躁程度的不同以 0.3～4 mg/（kg?h），持续或间歇静脉泵入；对照组20例给予地西泮5～10 mg肌注或缓慢静推。观察不同药物治疗患者的镇静效果、肝功能及血氨变化。 结果 观察组20 例患者应用丙泊酚治疗全部可达到满意镇静效果， 住院期间未发现肝性脑病加重及肝功能恶化表现；而对照组只有5例镇静效果满意，6例患者狂躁无明显改善，9例治疗期间出现肝性脑病进一步加重及肝功能恶化，7例血氨明显升高，2例死亡。 结论 丙泊酚可安全有效用于肝性脑病狂躁期患者。 　　[关键词] 丙泊酚 ；肝性脑病 ；狂躁；慢性肝病 　　[中图分类号] R747.9 [文献标识码] A [文章编号] 1674-0742（2016）09（c）-0131-04 　　[Abstract] Objective To observe the adverse reaction and clinical effect of propofol on hepatic encephalopathy in manic phase. Methods Convenient select in January 2010―Apirl 2016 40 patients with manic performance of hepatic encephalopathy were randomly divided into 2 groups， based on the diet and medical therapy，the observation group（20 cases） received propofol， initially given propofol 100 mg intravenous injection， then according to different degrees of manic patients to 0.3～4 mg/（kg?h）， persistent or intermittent intravenous pumping； 20 cases in the control group were given diazepam 5～10 mg intramuscular injection or slowly bolus， To observe the sedative effect， liver function and blood ammonia changes of patients with different drug treatment. Results 20 cases in observation group treated with propofol all can achieve satisfactory sedation， during hospitalization hepatic encephalopathy increased and exacerbation of severe liver function damage performance not found； while the control group only 5 cases achieved satisfactory sedative effect， 6 cases manic no obviously improved， deterioration of hepatic encephalopathy and exacerbation of liver function occurred in 9 patients during the treatment， 7 cases of blood ammonia increased significantly， 2 cases of death. Conclusion Propofol is safe and effective for patients in the manic phase of hepatic encephalopathy. 　　[Key words] Propofol； Hepatic encephalopathy； Mania； Chronic liver disease 　　肝性脑病 （hepat