大肠癌术前不进行肠道准备的应用体会  

Analysis of clinical effects on preoperative non-routine enteric preparation for colorectal cancer

作　　者：朱晓峰[1] 张涛[1] 曾德强[1] 翁伟明[1] 

机构地区：[1]粤北人民医院胃肠外科,广东韶关512026

出　　处：《岭南现代临床外科》2013年第5期431-434,共4页Lingnan Modern Clinics in Surgery

摘　　要：目的探讨不行肠道准备在大肠癌手术中的应用价值。方法将2006年3月至2012年10月的80例择期大肠癌患者随机分成40例实验组和40例对照组,实验组手术前饮食不作限制,无肠道梗阻症状者可进普食,手术前1天可进半流质,手术前1天不给予抗生素肠道准备及机械性肠道准备;对照组手术前2天进半流质,手术前1天进全流,手术前1天22时开始禁食;术前1天口服庆大霉素和灭滴灵;有不全梗阻者予清洁灌肠;无梗阻者,口服清肠剂;围手术期预防性抗生素使用甲硝唑和头孢曲松。分析两组患者的术后恢复情况、术后并发症发生率及术后肠道菌群改变情况等。结果实验组的术后切口感染肺部感染、腹腔脓肿、术后肠吻合口瘘的发生率及术后首次排气时间和住院时间与对照组相比,无显著性差异(P>0.05);但实验组术后低钠血症的发生率低于对照组,且术后肠道菌群改变明显低于对照组,差异有显著性(P<0.05)。结论术前不进行肠道准备在大肠癌手术中是安全可行的。Objective To explore the application value of non-routine traditional bowel preparation in the colorectal cancer. Methods Eighty eolorectal cancer patients from march 2006 to October 2012 were randomly divided into experimental group （n=40 non-routine traditional bowel preparation） and control group （n =40 routine traditional bowel preparation）. The postoperative recovery and postoperative complications were compared between two groups. Results The postoperative complications in the two group had no statistically significance （P〉0.05）. But the incidence rate of hyponatremia in the experimental group was significantly lower than that of the control group （P〈 0.05 ）, and the flora imbalance of the experimental group was significantly lower than that of the control group （P〈0.05）. Conclusion Non-routine traditional bowel preparation in the colorectal cancer is safe and feasible.

关 键 词：大肠癌 机械性肠道准备 抗生素肠道准备 

分 类 号：R656.9[医药卫生—外科学]