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目的 观察术前 3种药物对梗阻性黄疸 (简称 :梗黄 )病人抗内毒素血症的治疗作用。方法 48例梗黄病人分 4组在术前分别给予一般治疗 (A组 ) ,口服胆酸钠 (B组 ) ,口服乳果糖 (C组 )和静脉滴注山茛菪碱 (D组 )处理 ,和 2 1例无黄疸病人进行手术前后内毒素 (ET)含量测定。结果 (1)入院时梗黄各组外周血ET水平差异无显著意义 (P >0 .0 5 ) ,但均显著高于无黄疸组 (P <0 .0 1) ;(2 )A组门静脉血ET水平明显高于外周血 (P <0 .0 5 ) ;A组手术后 5dET水平降低不明显 ,随后ET逐渐下降 ,d 15接近正常水平 ;(3)B ,C 2组用药后外周血ET水平明显下降 ,术后ET水平继续降低 ,B ,C2组门静脉血ET水平低于A组 (P <0 .0 5 ) ;(4 )D组用药后外周血和术中门静脉血ET水平明显低于A组 (P <0 .0 5 ) ,术后也保持低水平。结论 术前应用胆盐、乳果糖和山茛菪碱可有效地降低梗黄病人肠源性内毒素血症
Objective To observe the effect of three kinds of preoperative drugs on anti-endotoxemia in patients with obstructive jaundice (abbreviation: Chylous yellow). Methods Forty-eight cases of patients with acute myocardial infarction were divided into 4 groups: group A, oral sodium cholate (group B), oral lactulose (group C) and intravenous anisodamine (group D) , And 21 patients without jaundice before and after surgery to determine the content of endotoxin (ET). Results (1) There was no significant difference of ET levels in each group (P> 0.05), but both were significantly higher than those without jaundice (P <0.01); (2) Blood ET level was significantly higher than that of peripheral blood (P <0.05); the level of ET was not obvious at 5d after operation in group A, then ET gradually decreased and d15 was close to the normal level; (3) Peripheral blood (P <0.05); (4) The level of ET in peripheral blood and intraoperative portal vein blood in group D was significantly lower than that in group A Lower than that in group A (P <0.05), and remained low after operation. Conclusion Preoperative application of bile salts, lactulose and anisodamine can effectively reduce the intestinal endotoxemia