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目的观察门冬氨酸鸟氨酸联合醒脑静治疗肝性脑病的临床疗效。方法将64例肝性脑病患者随机分为观察组和对照组各32例,两组患者均给予无蛋白饮食、保肝、抗感染、维持水电解质平衡、降血氨药物应用、防治脑水肿等综合治疗。对照组在此基础上加用乙酰谷酰胺1g加入5%葡萄糖液250ml静滴,每日1次。观察组则给予门冬氨酸鸟氨酸7.5g加入5%葡萄糖液250ml静滴,每日1次;醒脑静注射液20ml加入10%葡萄糖液250ml静滴,每日1次。两组均以10d为1个疗程。观察两组患者的临床表现、血氨和肝功能指标的变化。结果观察组显效率50.0%,总有效率93.8%明显高于对照组的31.2%和81.2%(P<0.05);观察组神志达到清醒所需时间和数字连接试验(NCT)时间均较对照组明显缩短(P均<0.001),血氨和总胆红素(TBIL)水平均较对照组明显降低(P<0.05)。结论门冬氨酸鸟氨酸联合醒脑静治疗肝性脑病,能有效降低患者的血氨水平,缩短达到清醒所需时间,提高临床疗效,具有广阔的应用前景。
Objective To observe the clinical efficacy of ornithine aspartate combined with xingnaojing on hepatic encephalopathy. Methods Sixty-four patients with hepatic encephalopathy were randomly divided into observation group and control group, with 32 cases in each. Patients in both groups were given protein-free diet, liver protection, anti-infection, water and electrolyte balance, blood ammonia drug application, prevention and treatment of cerebral edema Comprehensive Treatment. The control group on this basis plus acetylglutamine 1g added 5% glucose 250ml intravenous infusion, once daily. Observation group was given aspartate ornithine 7.5g added 5% glucose 250ml intravenous infusion once daily; Xingnaojing injection 20ml 10% glucose solution 250ml intravenous infusion once daily. Both groups were 10d for a course of treatment. The clinical manifestations, blood ammonia and liver function indexes of two groups were observed. Results The effective rate of the observation group was 50.0%, the total effective rate was 93.8%, which was significantly higher than that of the control group (31.2% vs 81.2%, P <0.05) (P <0.001), blood ammonia and total bilirubin (TBIL) levels were significantly lower than the control group (P <0.05). Conclusions Aspartate ornithine combined with xingnaojing can treat hepatic encephalopathy, which can effectively reduce the level of blood ammonia, shorten the time needed for awake, and improve the clinical curative effect. It has broad application prospects.