乳果糖治疗肝性脑病和亚临床肝性脑病149例临床观察

目的 进一步评估乳果糖对肝硬化肝性脑病和亚临床肝性脑病的疗效。方法 观察乳果糖治疗前后患者的精神状态、扑翼状震颤、脑电图、静脉血氨浓度和数字连接试验的改善情况。结果 乳果糖对肝性脑病组的脑病表现总有效率达96.5％,治疗前后静脉血氨浓度和数字连接试验的改善均有非常显著性差异(P<0.01);亚临床肝性脑病组治疗前后血氨有非常显著性差异(P<0.01),数字连接试验有显著性差异(P<0.05)。在乳果糖治疗观察期间,无一例亚临床肝性脑病患者发展为肝性脑病。结论 乳果糖适合于肝硬化肝性脑病和亚临床肝性脑病患者长期服用,可作为预防和治疗肝性脑病的常规用药。

Lactulose in 149 cases of hepatic encephalopathy and subclinical hepatic encephalopathy

Objective To further assess the treatment efficacy of lactulose in cirrhosis patients with hepatic encephalopathy and subclinical hepatic encephalopathy. Methods To observe the improvement of mental status, asterixis, electroencephalogram (EEG), venous ammonia concentration and the number connection test before and after treatment with lactulose. Results In the hepatic encephalopathy group, the total effective rate of encephalopathy is 96. 5% moreover the venous ammonia concentration and the number connection test after lactulose therapy are significantly higher than that before treatment (P <0. 01). In the subclinical hepatic encephalopathy group,the venous ammonia concentration after lactulose therapy is significantly higher than that before treatment (P<0. 01) and the number connection test is significance of difference (P<0. 05). No patient with subclinical hepatic encephalopathy developed to hepatic encephalopathy during lactulose treatment. Conclusion Lactulose is suitable to the long-term administration of the cirrhosis patients with hepatic encephalopathy or subclinical hepatic encephalopathy. It can be used as a routine medicine to prevent and treat the hepatic encephalopathy.