肝性脑病保留灌肠方法临床观察与分析.docVIP

肝性脑病保留灌肠方法临床观察与分析 　　[摘要] 目的：探讨肝性脑病的有效保留灌肠方法。方法：以随机抽样按序编组为原则将96例肝性脑病患者分为两组。试验组保留灌肠前先清洁肠道，取右侧卧位，肛管插入＞25 cm；对照组不清洁肠道，取左侧卧位，肛管插入＜20 cm。分析两组灌肠后灌肠液在肠腔内的保留时间和第1次灌肠8 h后血氨下降幅度的总有效率，并以χ2检验判断其差异有无统计学意义。结果：试验组灌肠液在肠腔内的保留时间、血氨下降幅度的总有效率均明显优于对照组（均P＜0.01）。结论：在点滴保留灌肠的前提下，保留灌肠前先清洁肠道、取右侧卧位和肛管深插方法能大大减少灌肠液返流入直肠，不会或极少会立即出现排便反射，使灌肠液在肠内保留时间更长，减少氨产生和吸收的效果更显著。 　　[关键词] 肝性脑病；保留灌肠；观察；分析 　　[中图分类号] R575 [文献标识码] Ａ [文章编号] 1673-7210（2012）01（a）-045-02 　　 　　Clinical observation and analysis of retention enema for hepatic encephalopathy ZHANG Yan 　　Department of Gastroenterology, Jingzhou Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology, Hubei Province, Jingzhou 434020, China 　　[Abstract] Objective: To explore the effective way of retention enema in the treatment of hepatic encephalopathy. Methods: 96 cases of hepatic encephalopathy patients were divided into two groups with the principle of random sampling and serial number grouping. In experiment group, the patients were cleaned the intestinal tract before retention enema, right lateral decubitus, and their insertion depth of anal tube 25 cm. In the control group, the patients were not cleaned the intestinal tract, left lateral decubitus, and their insertion depth of anal tube 20 cm. The total effective rates of both retention time of liquid in the intestinal cavity after enema and decline of blood ammonia 8 hours after enema were analyzed. And χ2 test was adopted to analyze the significant difference. Results: The total effective rates of the retention time of liquid in the intestinal cavity and decline of blood ammonia of the experiment group were significantly better than those of the control group (P0.01). Conclusion: On the premise of dripping retention enema, cleaning the intestinal tract before retention enema, adopting right lateral decubitus, and using the method of anal tube deep insertion can dramatically reduce the backflow of liquid into the rectum, rarely or immediately appear defecat