围手术期厚朴排气合剂在腹腔镜结直肠癌快速康复中疗效的随机对照研究  

A Randomized Controlled Study on Efficacy of Perioperative Administration of Houpupaiqi Mixture on Fast Track Surgery in Patients With Laparoscopic Colorectal Cancer

作　　者：仇伊尔 骆洋[1] 秦绍岚 崔然[1] 秦骏[1] 陈建军[1] 俞旻皓[1] 钟鸣[1] QIU Yier;LUO Yang;QIN Shaolan;CUI Ran;QIN Jun;CHEN Jianjun;YU Minhao;ZHONG Ming(Department of Gastrointestinal Surgery,Renji Hospital,School of Medicine,Shanghai Jiao Tong University,Shanghai,200127)

机构地区：[1]上海交通大学医学院附属仁济医院胃肠外科,200127

出　　处：《胃肠病学》2018年第3期148-151,共4页Chinese Journal of Gastroenterology

基　　金：上海市综合医院中西医结合专项(ZHYY-ZXYJHZX-2-17)资助

摘　　要：背景:研究表明厚朴排气合剂有助于开腹胃肠道手术患者的术后胃肠功能恢复,但目前尚缺乏其与腹腔镜结直肠癌术后胃肠功能恢复关系的随机对照研究。目的:探讨围手术期厚朴排气合剂在腹腔镜结直肠癌术后快速康复中的临床疗效。方法:采用前瞻性、随机、双盲对照的临床试验方法,纳入2016年1月—2017年2月上海交通大学医学院附属仁济医院170例结直肠癌患者。将患者随机分为试验组和对照组,于术前6 h、术后6 h和术后12 h分别经胃管给予厚朴排气合剂50 mL或厚朴排气合剂模拟剂50 mL。比较两组的疗效和安全性。结果:两组患者基线资料具有可比性。与对照相比,试验组患者术后首次肛门排气时间、术后规律肠鸣音出现时间和术后住院天数显著缩短(P<0.05),而两组术后首次排便时间、首次饮水时间、首次进食流质时间和首次进食固体食物时间均无明显差异(P>0.05)。两组各有1例患者发生吻合口瘘。结论:厚朴排气合剂对促进腹腔镜结直肠癌患者术后胃肠功能的恢复具有积极意义,能显著缩短肠鸣音恢复时间和肛门排气时间,同时缩短术后患者住院时间,符合快速康复这一理念。Background:Studies have shown that Houpupaiqi mixture is beneficial to the recovery of postoperative gastrointestinal function in patients undergoing open gastrointestinal surgery.However,there is no randomized controlled trial focusing on the efficacy of Houpupaiqi mixture on laparoscopic colorectal cancer patients.Aims:To investigate the efficacy of perioperative administration of Houpupaiqi mixture on fast track surgery in patients with laparoscopic colorectal cancer.Methods:A total of 170 colorectal cancer patients at Renji Hospital from January 2016 to February 2017 were enrolled into the prospective randomized double-blind controlled clinical trial.The patients were randomly divided into experimental group and control group,and Houpupaiqi mixture(50 mL)or placebo(50 mL)were administered 6 hours before surgery,as well as 6 and 12 hours after surgery,respectively.The clinical efficacy and safety were compared between the two groups.Results:The patients in experimental and control groups were well balanced with respect to the baseline characteristics.Compared with the control group,time to first anal exhaust,time to recovery of regular bowel sounds and time of postoperative hospital stay were significantly decreased in experimental group(P<0.05).However,no significant differences were observed in first time to defecation,first time to drink,first time to eat fluid diet and first time to eat solid food between the two groups(P>0.05).One patient with anastomotic fistula was found in each group.Conclusions:Houpupaiqi mixture significantly promotes the recovery of gastrointestinal function of patients undergoing laparoscopic colorectal cancer surgery,with reduction of time to recovery of regular bowel sounds,time to first anal exhaust,and shortening the postoperative hospital stay,which is in favor of rapid rehabilitation.

关 键 词：厚朴排气合剂 腹腔镜 结直肠肿瘤 胃肠功能 快速康复外科 治疗 

分 类 号：R735.3[医药卫生—肿瘤]