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Colegio de Medicina Interna de México.

2016, Number 4

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Med Int Mex 2016; 32 (4)

Comparison of the administration of lactulose and metronidazol vs lactulose or metronidazol in the treatment of acute liver encephalopathy

Ramírez-Palma A, Muñoz-Hernández E, Melchor-López A

Language: Spanish
References: 15
Page: 420-425
PDF size: 628.08 Kb.


ABSTRACT

Background: Hepatic encephalopathy (HE) is a neuropsychiatric syndrome. HE is characterized for a cognitive and motor deficiency with different severity states. Despite HE has been treated for many years, there is not definitive evidence about the therapeutic effects.
Objetive: To analyze if a combined therapy of oral (OV) lactulose and intravenous (IV) metronidazole decrease the hospital stay compared with oral lactulose or IV or OV metronidazole monotherapy.
Material and Method: A retrospective study was made. We analyzed 60 medical records from patients with HE diagnosis (West Haven grade II-IV) from Xoco General Hospital, Mexico City. Patients were divided into three groups according with therapy: metronidazole + lactulose (n=23), metronidazole (n=24) and lactulose (n=13). Statistical analysis was made in VassarStats. ANOVA was used to compare differences between groups.
Results: When correlating the hospital stay with type of therapy administered for the three groups there was a value p=0.15. Variables as HE grade, type of therapy and hospital stay time correlated p=0.12 in patients with HE grade II and p=0.03 for HE grade III patients.
Conclusion: Monotherapy or combination of metronidazole and lactulose did not decrease the hospital stay of HE grade II patients. HE grade IV patients with metronidazole + lactulose therapy, however, had decreased hospital stay


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