| The serious multiple thoracic-abdominal injuries (SMTAI) almost with thetraumatic and hemorrhagic shock, surgical operation treatment is more needed. It hasno enough time to prepare for the operation, specially for gastrointestinal preparation,that may lead to gastrointestinal failure, hence inducting multiple organ dysfunctionsyndrome (MODS).Rhubarb is a traditional Chinese herbal drug with a effect of diarrhea anddetoxication. The present study has discovered that Rhubarb also has the variouspharmacology effects of anti-pain, anti-epiphyte, anti-virus, anti-tumor,immuno-modulating, etc. the poisonous and side effect are small. In recent years,there are a great deal of reports show that Rhubarb has therapeutical and preventiveeffects on gastrointestinal failure in critical illness, but few reports on therapeuticaland preventive effects of rhubarb on gastrointestinal function failure after operation ofserious multiple thoracic-abdominal injuries.This study observed the incidence of gastrointestinal failure and MODS in theserious multiple thoracic-abdominal injuries (SMTAI). This study observedtherapeutical and preventive effects of rhubarb on the patients who were cured byRhubarb before and after. This study shows its possible mechanism that the rhubarbcan treat and prevent the gastrointestinal failure and MODS after operation of seriousmultiple thoracic-abdominal injuries patients. Material and method1 Purpose1) Observe the effects of Rhubarb to prevent gastrointestinal failure and MODSafter operation of serious multiple thoracic-abdominal injuries.2) Observe the effects of Rhubarb to treat gastrointestinal failure and MODS afteroperation of serious multiple thoracic-abdominal injuries.3) Observe the effects of Rhubarb to affect pH inside lumen of the stomach andintestines after operation of serious multiple thoracic-abdominal injuries2 Research methods1) Experiment prevent grouping Choose 95 cases with serious multiplethoracic-abdominal injuries and ISS＞16, the second people's hospital in Zhengzhou,from January 2003 to June 2006, who already had emergency surgical operations.According to form couples with random principle, all patients were randomly dividedinto rhubarb prevention group and non-prevention group; observe the incidence rateof the gastrointestinal failure, toxic paralytic ileus, stress gastrointestinal ulcer andMODS, recovery time of intestines peristalsis and intestines nutrition.2) Experiment treatment grouping The patients with stress gastrointestinal ulcerand toxic paralytic ileus, who appear in the non-preventive group, are treated as theresearch objects in another rhubarb treatment group. H2-receptor blocker was treatedin the non-preventive comparison group, and study curtly rate of gastrointestinalstress ulcer, toxic paralytic ileus paralyze and MODS.3) Measure pH in the lumen of stomach and intestine Adopt the pH instrumentto measure pH in gastrointestinal lumen of patients, who appear in the rhubarbpreventive group and non-preventive group when they were treated with Rhubarbbefore and after. And study the influence whether the rhubarb could improve thegastrointestinal blood perfusion.3 The stastics analysis Count the data application X2 examinations withSPSS11.0 covariance software processing, with a significant difference (P＜0.05). Result1) The preventive effect of rhubarb on gastrointestinal failure and MODS afteroperation of serious multiple thoracic-abdominal injuriesThe incidence of stress ulceration is reduced from 64.4% to 14%, toxicgastrointestinal paralysis is reduced from 91.1% to 20%, and MODS was reducedfrom 40% to 12%. There is a significant difference between the two groups (P＜0.05).It is obviously lower in preventive group than that in non-preventive group. The timeof bowl movement and exhaust is earlier in the rhubarb preventive group thannon-preventive group in the same time (P＜0.05).2)The treatment effect of rhubarb on gastrointestinal failure and MODS afteroperation of serious multiple thoracic-abdominal injuriesThe cute rate of stress ulceration 78.9% is obviously higher in treatment group thanthat in non-treatment group 60% (P＜0.05), but the incidence of tissue bleeding rate47.4% in treatment group is higher than that in non-treatment group 30%(P＜0.05).The cure rate of toxic gastrointestinal paralysis 79.5% is obviously higher in treatmentgroup than that in non-treatment group25% (P＜0.05). and gastrointestinal nutritionrecovery in treatment group is 51.4% higher than 25% in non-treatment group(P＜0.05). The morbidity and mortality rate of MODS is obviously lower in treatmentgroup than that in non-treatment group (P＜0.05).3) The effect of rhubarb on pH in gastrointestinal lumen after operation of seriousmultiple thoracic-abdominal injuries The pH in stomach lumen of patients whoare operated on serious multiple thoracic-abdominal injuries in the rhubarb preventivegroup is much lower than that in the control group, whereas rhubarb could obviouslydecrease stomach pH (P＜0.05). The pH in intestine lumen of patients who areoperated on serious multiple thoracic-abdominal injuries is much higher than that inthe control group, whereas rhubarb could obviously elevate intestinal pH (P＜0.05). It shows that rhubarb may improve the gastrointestinal blood perfusion early andrestores gastrointestinal function.Conclusion1,The preventive usage of rhubarb could decrease the incidence rate ofgastrointestinal failure and the morbidity of MODS after operation of serious multiplethoracic-abdominal injuries.2,The rhubarb can treat the gastrointestinal failure and reduce mortality of MODSafter operation of serious multiple thoracic-abdominal injuries.3,The rhubarb could restore the pH inside the lumen of stomach and intestine afteroperation of serious multiple thoracic-abdominal injuries by improving thegastrointestinal early blood perfusion.CreationThere is no this study domestically and abroad that therapeutical and preventiveeffects of rhubarb on gastrointestinal failure after operation of serious multiplethoracic-abdominal injuries... |
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