莫沙必利联合多潘立酮对肠内营养期结直肠癌患者胃肠功能的影响  

Effect of mosapride combined with domperidone on gastrointestinal function in enteral nutrition patients with colorectal cancer

作　　者：王瑶[1] 于玲[2] 曹文文 WANG Yao;YU Ling;CAO Wen-wen(Department of Gastroenterology,Qingdao Municipal Hospital,Qingdao,Shandong 266000;General Surgery Department of Qingdao Municipal Hospital,Qingdao,Shandong 266000;Department of Critical Care Medicine,Eastern Hospital of Qingdao Municipal Hospital,Qingdao,Shangdong 266000)

机构地区：[1]山东省青岛市市立医院消化内科,266000 [2]山东省青岛市市立医院普外二科,266000 [3]山东省青岛市市立医院东院区重症医学科,266000

出　　处：《现代消化及介入诊疗》2019年第4期347-351,共5页Modern Interventional Diagnosis and Treatment in Gastroenterology

基　　金：山东省医药卫生科技发展计划项目(2017WSA14022)

摘　　要：目的研究莫沙必利联合多潘立酮对结直肠癌患者术后肠内营养期胃肠功能影响。方法将240例接受结直肠癌根治术的患者作为研究对象,随机抽签分为四组,每组各60例。四组患者术后均接受肠内营养,A、B组分别接受莫沙必利或多潘立酮治疗,C组给予莫沙必利联合多潘立酮方案治疗,D组为阴性对照组。比较四组患者手术基本情况、术后胃肠功能恢复和术后腹泻发生情况,检测血清ghrelin变化水平。结果四组患者手术和麻醉方式、手术时间、术中出血量及拔管时间均无显著性差异(P> 0. 05)。C组术后肠鸣音恢复时间、术后首次排气、排便时间及进流质饮食时间均显著早于其他三组(P <0. 05),C组腹泻发生率和持续时间均高于/长于其他三组(P> 0. 05),四组腹泻严重程度无显著性差异(P> 0. 05)。C组干预后血清ghrelin显著高于其他三组和干预前(P <0. 05)。患者血清ghrelin水平与肠鸣音恢复时间呈负相关性(r=-0. 952),与腹泻持续时间呈正相关性(r=0. 980)。结论肠内营养期联合应用莫沙必利和多潘立酮能显著缩短结直肠癌患者术后胃肠功能恢复时间,但也可能增加腹泻风险,这可能与血清ghrelin有关,临床应注意防控。Objective To study the effect of mosapride combined with domperidone on gastrointestinal function in patients with colorectal cancer in enteral nutrition.Methods A total of 240 patients underwent radical resection of colorectal cancer were randomly divided into four groups,60 cases in each group.All patients received enteral nutrition after operation.Group A and B received mosapride or domperidone respectively,group C received mosapride combined with domperidone regimen,and group D was a negative control group.The basic conditions of operation,recovery of gastrointestinal function and occurrence of diarrhea after operation were compared among the four groups,and the changes of serum ghrelin were detected.Results There were no significant difference between the four groups in terms of operation and anesthesia,operation time,intraoperative blood loss and extubation time(P>0.05).The recovery time of bowel sounds,the first exhaust,defecation time and the time of intaking liquid diet in group C were significantly earlier than those in other three groups(P<0.05).The incidence and duration of diarrhea in group C were higher than those in other three groups(P>0.05).There was no significant difference in the severity of diarrhea between the four groups(P>0.05),the serum ghrelin in group C after intervention was significantly higher than those of other three groups and before intervention(P<0.05).The serum ghrelin level was negatively correlated with the recovery time of bowel sounds(r=-0.952)and positively correlated with the duration of diarrhea(r=0.980).Conclusion The combined use of mosapride and domperidone during enteral nutrition period can significantly shorten the recovery time of gastrointestinal function in patients with colorectal cancer after operation,but it may also increase the risk of diarrhea,which may be related to serum ghrelin.Clinical prevention and control should be paid attention to.

关 键 词：结直肠癌 肠内营养期 莫沙必利 多潘立酮 

分 类 号：R735[医药卫生—肿瘤]