术前机械性肠道准备对结肠癌患者早期康复疗效的影响:随机对照试验

发布时间：2018-07-11 18:10

本文选题：结肠癌 + 机械性肠道准备　；参考：《南方医科大学学报》2017年01期

【摘要】：目的对比"进行"或"不进行"术前机械性肠道准备对结肠癌患者术后早期康复效果的影响,探讨我国结肠癌患者群术前不进行机械性肠道准备的可行性。方法选择某三级甲等医院胃肠外科中心2014年7月~2016年2月期间某医疗组收治的需行择期一期吻合性切除术的结肠癌患者随机分为试验组和对照组,试验组患者不进行机械性肠道准备,对照组患者术前12 h进行机械性肠道准备。术后12 h内完成基线资料指标收集,患者的血红蛋白、总蛋白、白蛋白、前白蛋白及白球比等指标以术前1 d、术后第1和5天的数据为准,随访出院后至术后第30天患者并进行统计分析。结果最终纳入试验组76人,对照组72人。两组伤口感染,腹腔感染发生率的差异有统计学意义(P0.05)。吻合口瘘及术后早期肠梗阻的发生率差异无统计学意义(P0.05)。两组患者术后首次排气时间差异有统计学意义(P=0.03)。两组患者术后第1天的前白蛋白差异有统计学意义(P=0.03),手术时间比较差异无统计学意义(P=0.06)。结论结肠癌术前进行机械性肠道准备增加术后早期并发症发生率,延迟肠道运动功能恢复,影响术后早期营养状态。
[Abstract]:Objective to compare the effect of mechanical bowel preparation before and after operation on the early rehabilitation of patients with colon cancer, and to explore the feasibility of mechanical bowel preparation before operation in Chinese patients with colon cancer. Methods from July 2014 to February 2016, colon cancer patients in a Grade 3A hospital were randomly divided into trial group and control group. The patients in the experimental group were not prepared for mechanical bowel, while the patients in the control group were prepared for the mechanical bowel 12 hours before operation. Baseline data were collected within 12 hours after operation. Hemoglobin, total protein, albumin, prealbumin and white ball ratio were measured at 1 day before operation and 1 and 5 days after operation. The patients were followed up from discharge to 30 days after operation and analyzed statistically. Results 76 patients were included in the trial group and 72 in the control group. There was significant difference in the incidence of wound infection and abdominal infection between the two groups (P0.05). There was no significant difference in the incidence of anastomotic fistula and early postoperative intestinal obstruction (P0.05). There was significant difference in the first time of exhaust between the two groups (P0. 03). There was a significant difference in prealbumin between the two groups on the first day after operation (P0. 03), but there was no significant difference in the operation time (P0. 06). Conclusion the mechanical bowel preparation before operation increases the incidence of early postoperative complications, delays the recovery of intestinal motor function, and affects the early nutritional status after operation.
【作者单位】：四川大学华西医院;
【基金】：四川省科技厅项目(2013SZ0026)
【分类号】：R735.35

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