不同时机应用大承气汤对危重症患者肠道复苏的影响

目的探讨不同时机应用大承气汤对危重症患者肠道复苏的影响。方法将APPACHEⅡ评分在12～20分、存在肠功能障碍患者110例随机分为3组,甲组给予常规肠道复苏,乙组于肠道复苏前应用大承气汤,丙组于肠道复苏后应用大承气汤,观察3组治疗前后肠功能障碍评分等级、营养治疗耐受程度、腹腔器官感染率、肠道细菌全身感染率。结果乙组与甲组、丙组治疗后肠功能障碍评分、肠内营养比率、肠内营养+肠外营养比率比较均有显著性差异(P均<0.05);3组肠外营养比率比较无显著性差异。乙组与甲组、丙组腹腔器官感染率、肠道细菌全身感染率比较均有显著性差异(P均<0.05)。甲组与丙组各项指标比较无显著性差异。结论肠道复苏前应用大承气汤效果优于肠道复苏后应用;肠道复苏后应用大承气汤和常规肠道复苏对危重症患者的影响无明显差异。

Effect of Dachengqi decoction used in different time on intestinal recovery of patients with critical illness

Objective It is to explore the effect of Dachengqi decoction ursed in different time on intestinal recovery of patients with critical illness.Methods The patients with APPACHE Ⅱ score 12-20 points and bowel dysfunction were randomly divided into 3 groups,Group A received routine intestinal recovery,group B received Dachengqi decoction before the application of the intestinal recovery,Group C received Dachengqi decoction after the application of recovery.Intestinal dysfunction grade,tolerance of nutrition therapy,abdominal organs infection,systemic bacterial infection in the groups was observed before and after treatment.Results Comparing group B to group A,group C after treatment,intestinal dysfunction score,enteral nutrition rate,rate of enteral nutrition + parenteral nutrition were significantly different(all P<0.05);The ratio of parenteral nutrition showed no significant difference among 3 groups.Comparing group B to group A and group C,the rate of the abdominal organs infection,systemic bacterial infection were significant different(P<0.05).The indicators showed no significant difference between group A and group C.Conclusion The effect of application of Dachengqi decoction before intestinal recovery was better than that after intestinal recovery application;Comparing routine intestinal recovery to received Dachengqi decoction after the application of recovery in the patients with critical illness,there was no significant different.