Therapeutic and preventive effects of early drugs intervention on intestinal dysfunction in sepsis patients

doi:10.3969/j.issn.1002-1949.2015.04.004

Abstract：Objective To study the therapeutic and preventive effects of early drugs intervention on intestinal dysfunction in sepsis patients.Methods All of 92 sepsis cases which were not complicated with intestinal dysfunction were randomly divided into intervention group and control group. Two groups were treated with the same conventional therapy.The patients of intervention group were given trimebutine maleatein and bifico for above 7 days by oral or nasal feeding, and physiological saline for control group. The blood plasma levels of diamine oxidase ( DAO ) activity and D -lactate concentration were tested by enzyme linked immunosorbent assay ( ELISA) before the treatment, and on 3rd, 5th, 7th day after admission in both groups.We also analyzed the rate of enteral nutrition tolerance and MODS incidence, 28d-fatality rate, the score of intestinal function and APACHEⅡ.Results①Four cases of intervention group and five cases of control group were expelled, because of inconformity the research standard.②The blood plasma level of DAO activity and D-lactate concentration were not significantly difference between the two groups before treatment (P>0.05), but compared with control group, DAO activity and D-lactate concentration were significantly lower in intervention group on 7 th day.The blood plasma levels of DAO activity and D-lactate concentration were highest in both two groups before treatment. With the time passing by, levels of the two indicators were decreased significantly in both two groups too ( P <0.05 ) .③Compared with the control group, the scores of intestinal function were significantly lower in intervention group on 5th, 7th day (5th day P<0.05, 7th day P<0.01), and the rate of enteral nutrition tolerance was lower on 5th, 7th day too, but statistical differences appeared on 7th day (P<0.05).④Compared with the control group, the score of APACHEⅡwas significantly lower in intervention group (P<0.05),the incidence rate of MODS was lower too (11.9%vs 29.3%, P<0.05).The rate of 28d-case fatality of intervention group (4.76 %) was lower than control group (14.63%), but this difference was not statistically significant (P>0.05). Conclusion It is more effective to decrease the incidence rate of intestinal dysfunction, better for enteral nutrition implementation, then improve the prognosis of patients with sepsis by early intervention treatment with trimebutine maleatein and bifico.