乳果糖预防肝硬化消化道出血后诱发肝性脑病的meta分析

发布时间：2019-06-15 05:27

【摘要】：目的探讨乳果糖制剂用于预防肝硬化消化道出血后诱发肝性脑病发生的疗效评价。方法计算机检索PubMed、Wiley、The Cochrane Central Register of Controlled Trials外文数据库及CNKI相关期刊论文、万方数字化期刊全文数据库、维普中文科技期刊全文数据库中文数据库中有关乳果糖预防肝硬化消化道出血后诱发肝性脑病发生的临床随机对照试验,采用RevMan5.0软件对入选试验进行Meta分析。结果共5项随机对照试验符合入选标准,包括318例患者。Meta分析结果显示:乳果糖制剂可以明显降低肝硬化消化道出血病人肝性脑病的发生率(RR=0.20,95%CI:0.10~0.40,P0.000 01),有效降低血氨水平(WMD=-9.10,95%CI:-11.48~-6.73,P0.000 01),缩短数字连接试验所需的反应时间(WMD=-14.48,95%CI:-20.08~-9.60,P0.000 01)。结论乳果糖制剂可改善肝硬化消化道出血患者部分指标,对预防肝硬化消化道出血患者肝性脑病的发生有一定疗效。
[Abstract]:Objective to evaluate the efficacy of lactulose preparation in preventing hepatic encephalopathy induced by gastrointestinal bleeding in cirrhotic patients. Methods the PubMed,Wiley,The Cochrane Central Register of Controlled Trials foreign language database, CNKI Chinese journal full-text database, Wanfang digital journal full-text database and Weipu Chinese sci-tech journal full-text database were searched by computer for clinical randomized controlled trials of lactulose in preventing hepatic encephalopathy after gastrointestinal bleeding in cirrhotic patients. Meta software was used to analyze the selected trials. Results A total of 5 randomized controlled trials met the selection criteria, including 318 patients. Meta-analysis showed that lactulose preparation could significantly reduce the incidence of hepatic encephalopathy (RR=0.20,95%CI:0.10~0.40,P0.000 01) and blood ammonia level (WMD=-9.10,95%CI:-11.48~-6.73,P0.000 01) in patients with liver cirrhosis and gastrointestinal bleeding. Shorten the reaction time required for digital connection test (WMD=-14.48,95%CI:-20.08~-9.60,P0.000 01). Conclusion lactulose preparation can improve some indexes of cirrhotic gastrointestinal bleeding patients and has certain curative effect on preventing hepatic encephalopathy in cirrhotic gastrointestinal bleeding patients.
【作者单位】：武汉大学人民医院消化系病研究所;
【基金】：武汉大学种子基金(523-266078)
【分类号】：R575.3

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