力尔宁在腹腔镜结直肠癌患者加速康复治疗中的临床研究  

Application of octreotide acetate injection in the enhanced recovery after surgery of patients with colorectal cancer after laparoscopic surgery

作　　者：苏昊[1,2] 包满都拉 王鹏 刘骞[1,2] 王锡山 周志祥[1,2] 周海涛 SU Hao;BAO Mandula;WANG Peng;LIU Qian;WANG Xishan;ZHOU Zhixiang;ZHOU Haitao(Department of Colorectal Surgery,National Cancer Center/Cancer Hospital,Chinese Academy of Medical Science and Peking Union Medical College,Beijing 100021,China)

机构地区：[1]国家癌症中心中国医学科学院肿瘤医院结直肠外科,北京100021 [2]国家肿瘤临床医学研究中心,100021

出　　处：《临床肿瘤学杂志》2018年第7期626-630,共5页Chinese Clinical Oncology

基　　金：2017年度北京市东城区优秀人才培养专项;中国癌症基金会北京希望马拉松基金项目(LC2016B10);中国医学科学院医学与健康科技创新工程(协同创新团队项目)(2017-I2M-4-002)

摘　　要：目的探讨醋酸奥曲肽(力尔宁)在腹腔镜结直肠癌患者加速康复治疗中的临床应用。方法收集2014年10月至2016年9月期间行腹腔镜结直肠癌手术的患者,随机分为力尔宁组(103例)和对照组(51例)。两组术后均不留置鼻胃管,对照组采用加速康复常规治疗,力尔宁组在加速康复常规治疗的基础上加用力尔宁0.2 mg皮下注射,每8 h 1次,治疗3 d。观察两组术后治疗效果、术后并发症、再次置鼻胃管及术后排气时间、住院时间的差异。结果力尔宁组5例术后出现腹胀,8例术后出现恶心、呕吐等不适,对照组中9例出现腹胀,10例发生恶心、呕吐,两组比较差异有统计学意义(P<0.05)。力尔宁组有5例、对照组有3例均出现鼻咽部不适,两组差异无统计学意义(P>0.05)。力尔宁组有3例、对照组有3例因术后肠梗阻、腹胀恶心严重而再次置鼻胃管,两组差异无统计学意义(P>0.05)。两组在术后肠梗阻、肺部感染、吻合口漏等并发症方面以及术后恢复排气时间、住院时间方面无明显差异(P>0.05)。结论力尔宁可以有效减少腹腔镜结直肠癌患者术后的腹胀及恶心呕吐,可在术后常规安全使用。Objective To explore the efficacy of octreotide acetate(OA)injection in the enhancement of colorectal cancer(CRC)patient s recovery following laparoscopic surgery.Methods From October 2014 to September 2016,CRC patients who underwent laparoscopic surgery and did not indwell nasogastric tubes after surgery were divided into 2 groups:OA group(103 patients),who received routine therapy plus OA injection at a dose of 0.2 mg ih q8h for 3 days and control group(51 patients)subjected only to routine therapy.Patients of the two groups were observed for nasopharynx discomfort,abdominal distention,nausea,vomiting,intestinal obstruction,pulmonary infection,anastomotic leakage,rein dwelling nasogastric tubes,the first passage of flatus and hospital stay.Results Five patients suffered from postoperative abdominal distention in the OA group,less than 9 patients in the control group(P<0.05).Eight patients suffered from postoperative nausea and vomiting in the OA group,less than 10 patients in the control group(P<0.05).Five patients suffered from postoperative nasopharynx discomfort in the OA group,similar with 3 patients in the control group(P>0.05).Three patients in the OA group and 3 patients in the control group reined dwelling nasogastric tubes because of intestinal obstruction or severe nausea and vomiting,and there was no statistic difference significantly between two groups(P>0.05).In addition,postoperative intestinal obstruction,pulmonary infection,anastomotic leakage,the first passage of flatus and hospital stay remained unchanged between the two groups(P>0.05).Conclusion OA injection can effectively reduce abdominal distention and nausea and vomiting after laparoscopic CRC surgery,and can be used safely after operation.

关 键 词：结直肠癌 醋酸奥曲肽 腹腔镜手术 加速康复 

分 类 号：R735.35[医药卫生—肿瘤] R735.37[医药卫生—临床医学]