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- Title
Comparación individual de tres terapias antiamonio en el tratamiento de la encefalopatía hepática.
- Authors
Dávila-Sosa, D.; Avilés-Rosas, G.; Lozano-Nuevo, J. J.; Vargas-Ayala, G.; Rodríguez-López, L.
- Abstract
BACKGROUND : Hepatic encephalopathy is a clinical picture comprising a variety of neuropsychological disorders in cognitive and emotional areas, personality, motor activity, memory and consciousness, being able to progress to coma. Treatment with lactulose and metronidazole has improved the prognosis; however, there are patients with poor response to this therapy. OBJECTIVE: To compare the effectiveness of different antiamonio therapies coupled to the therapeutic measures of the precipitating cause, such as treatment of hepatic encephalopathy. MATERIAL AND METHOD: An experimental, comparative, longitudinal, prospective, controlled and blinded clinical trial. A total of 88 patients were randomized into three groups: group A lactulose (n=30) group B metronidazole (n=29) and group C LOLA (n=29); degree of hepatic encephalopathy was determined and venous blood simple was taken to measure ammonia levels, treatment was initiated based on lactulose or metronidazole or Hepa-Merz®. Ammonium was determined again and degree of encephalopathy was determined at hospital discharge. RESULTS: The average age of the patients was 51.3±10.3, 51.8±15.2 and 48.3±13.4 years, respectively; p=0.264 when comparing the groups according to the degree of hepatic encephalopathy at admission and discharge was obtained. In addition, p=0.207 when comparing the length of hospital stay was obtained. Finally quantity ammonium was compared before and after treatment obtaining a p=0.028 in the lactulose group and p=0.009 in the Hepa-Merz® group, without finding significance for the metronidazole group (p=0.294). CONCLUSIONS: Treatment with lactulose and Hepa-Merz® significantly reduces ammonia concentration in patients with hepatic encephalopathy, with no differences in terms of relief of hepatic encephalopathy or days of hospital stay.
- Publication
Medicina Interna de Mexico, 2016, Vol 32, Issue 3, p284
- ISSN
0186-4866
- Publication type
Article