CAJ | 학술논문

目的评价不同剂量乳果糖对口服吗啡制剂所致便秘的疗效.方法回顾性分析上海长征医院肿瘤科2011年1月至2012年5月使用乳果糖口服溶液预防口服吗啡所致便秘患者的临床资料,共有112例口服吗啡的患者入组,其中男52例,女60例,按其乳果糖服用剂量不同分为3组,分别接受30、60、90 ml每日顿服乳果糖口服液给药,分别为40、43、29例.吗啡为口服给药,并根据疼痛评分调整剂量,其与乳果糖同时使用.分析患者用药后1周便秘和不良反应的发生率.对于计量数据采用方差分析,计数数据采用x2、Kruskal-Wallis和Mann-Whitney U检验.结果乳果糖30、60、90 ml组便秘发生率分别为67.5％(27/40)、46.5％(20/43)和37.9％(11/29),差异有统计学意义(P=0.036).30 ml和60 ml组、60 ml和90 ml组差异均无统计学意义(P=0.054、0.471),30 ml组明显高于90 ml组(P=0.015).90 ml组呕吐发生率均高于30和60 ml组[34.5％ (10/29)比10.0％(4/40)和9.3％ (4/43),P=0.013和0.009],后两组差异无统计学意义(P=0.915).90 ml腹泻发生率明显高于30 ml组[17.2％ (5/29)比0,P=0.007],与60 ml组[4.7％(2/43)]差异无统计学意义(P =0.072),60与30 ml组比较差异亦无统计学意义(P=0.170).结论 60 ml/d的乳果糖口服溶液是预防性吗啡所致便秘较为合适的剂量.
목적 평개불동제량유과당대구복마배제제소치편비적료효.방법 회고성분석상해장정의원종류과2011년1월지2012년5월사용유과당구복용액예방구복마배소치편비환자적림상자료,공유112례구복마배적환자입조,기중남52례,녀60례,안기유과당복용제량불동분위3조,분별접수30、60、90 ml매일돈복유과당구복액급약,분별위40、43、29례.마배위구복급약,병근거동통평분조정제량,기여유과당동시사용.분석환자용약후1주편비화불량반응적발생솔.대우계량수거채용방차분석,계수수거채용x2、Kruskal-Wallis화Mann-Whitney U검험.결과 유과당30、60、90 ml조편비발생솔분별위67.5％(27/40)、46.5％(20/43)화37.9％(11/29),차이유통계학의의(P=0.036).30 ml화60 ml조、60 ml화90 ml조차이균무통계학의의(P=0.054、0.471),30 ml조명현고우90 ml조(P=0.015).90 ml조구토발생솔균고우30화60 ml조[34.5％ (10/29)비10.0％(4/40)화9.3％ (4/43),P=0.013화0.009],후량조차이무통계학의의(P=0.915).90 ml복사발생솔명현고우30 ml조[17.2％ (5/29)비0,P=0.007],여60 ml조[4.7％(2/43)]차이무통계학의의(P =0.072),60여30 ml조비교차이역무통계학의의(P=0.170).결론 60 ml/d적유과당구복용액시예방성마배소치편비교위합괄적제량.
Objective To evaluate the effects of different doses of lactulose on preventing oral morphine-induced constipation.Methods From January 2011 to May 2012,a total of 112 patients received oral lactulose solution to prevent morphine-induced constipation at our hospital and their clinical data were retrospectively analyzed.The doses of morphine were adjusted according to the pain scores and lactulose was taken simultaneously.There were 52 males and 60 females.They were randomized into Group 30 ml/d (n =40),Group 60 ml/d (n =43) and Group 90 ml/d (n =29).The incidences of constipation and adverse reactions were obtained at 1 week after the start of medicine.The measurement data were analyzed with analysis of variance.And the enumeration data were analyzed with x2,Kruskal-Wallis and Mann-Whitney U tests.Results The incidence of constipation was 67.5％ (27/40) in Group 30 ml/d,46.5％ (20/43) in Group 60 ml/d,and 37.9％ (11/29)in Group 90 ml/d.And there were statistical differences(P =0.036).The incidence of constipation in Group 30 ml was significantly higher than Group 90 ml/d(P =0.015).No statistical difference existed in the incidence of constipation between Groups 30 ml/d and 60 ml/d (P =0.054) or Groups 60 ml/d and 90 ml/d (P =0.471).The incidence of vomiting was 34.5％ (10/29) in Group 90 ml/d and it was significantly higher than 10.0％ (4/40) in Group 30 ml/d (P =0.013) and 9.3％ (4/43) in Group 60 ml/d (P =0.009).No statistical difference existed in the incidence of vomiting between Groups 30 ml/d and 60 ml/d (P =0.915).The incidence of diarrhea was 17.2％ (5/29) in Group 90 ml/d and it was significantly higher than 0 (0/40) in Group 30 ml/d (P =0.007).No statistical difference existed in the incidence of diarrhea between Groups 30 ml/d and 60 ml/d (4.7％ (2/43),P =0.170) or Groups 60 ml/d and 90 ml/d (P =0.072).Conclusion The correct dosage of lactulose for the prevention of oral morphine-induced constipation is 60 ml/d.