甘露醇联合口服补液盐对老年乳腺癌根治术患者术后肠功能恢复情况及肠道清洁度的影响  

Effect of mannitol combined with oral rehydration salts on intestinal function recovery and intestinal cleanliness in elderly patients undergoing radical surgery of breast cancer

作　　者：訾聪娜[1] 马先 滕金亮[1] 樊娟[1] 李艳明 Zi Congna;Ma Xian;Teng Jinliang;Fan Juan;Li Yanming(Department of Anesthesiology,the First Affiliated Hospital of Hebei North University,Hebei Province,Zhangjiakou 075000,China;Department of Blood Transfusion,the First Affiliated Hospital of Hebei North University,Hebei Province,Zhangjiakou 075000,China;Department of Operating Room,the First Affiliated Hospital of Hebei North University,Hebei Province,Zhangjiakou 075000,China)

机构地区：[1]河北北方学院附属第一医院麻醉科,河北省张家口市075000 [2]河北北方学院附属第一医院输血科,河北省张家口市075000 [3]河北北方学院附属第一医院手术室,河北省张家口市075000

出　　处：《中国医药》2020年第4期569-572,共4页China Medicine

基　　金：河北省医学科学研究课题计划(20190889)。

摘　　要：目的探究甘露醇联合口服补液盐对老年乳腺癌根治术患者术后肠功能恢复情况及肠道清洁度的影响。方法选取2018年10月至2019年3月河北北方学院附属第一医院收治的拟行老年乳腺癌根治术患者80例,按随机数字表法分为对照组(40例)和观察组(40例)。对照组口服20%甘露醇注射液进行肠道准备;观察组在对照组基础上联合口服补液盐进行肠道准备。比较2组患者排便情况,肠道清洁程度,手术前后血糖、电解质的变化,术后首次肛门排气时间和不良反应发生情况。结果观察组患者首次排便时间和排便清澈时间与对照组比较,差异均无统计学意义(均P>0.05),观察组排便次数少于对照组[(4.7±1.4)次比(5.6±2.5)次],肠道清洁率高于对照组[85.0%(34/40)比65.0%(26/40)],术后晨血糖水平低于对照组[(5.3±1.1)mmol/L比(6.8±1.4)mmol/L],电解质(Na^+、K^+、Cl^-)水平高于对照组[(136.9±1.0)mmol/L比(135.6±1.1)mmol/L、(4.1±0.5)mmol/L比(3.7±0.6)mmol/L、(102.8±2.1)mmol/L比(99.8±2.4)mmol/L],差异均有统计学意义(均P<0.05)。观察组术后首次肛门排气时间明显短于对照组[(29±8)h比(39±12)h],不良反应发生率明显低于对照组[7.5%(3/40)比25.0%(10/40)](均P<0.05)。结论甘露醇联合口服补液盐用于老年乳腺癌根治术的术前肠道准备中,不仅肠道清洁效果良好,而且可以稳定血糖和电解质水平,促进肠道功能的恢复,减少不良反应的发生。Objective To explore the effect of mannitol combined with oral rehydration salts on intestinal function recovery and intestinal cleanliness in elderly patients undergoing radical mastectomy. Methods From October 2018 to March 2019,80 patients with breast cancer undergoing radical mastectomy in the First Affiliated Hospital of Hebei North University were randomly divided into control group( 40 cases) and observation group(40 cases). The control group took 20% mannitol injection and the observation group used oral rehydration salts additionally for intestinal preparation. Defecation,intestinal cleanliness,blood glucose,electrolytes,postoperative first anal exhaust time and adverse reactions were analyzed. Results There were no significant differences in the first defecation time and clear defecation time between groups( both P > 0. 05). Defecation frequency in observation group was significantly less than those in control group[(4. 7 ± 1. 4) vs(5. 6 ± 2. 5)]( P < 0. 05). Intestinal cleaning rate in observation group was significantly higher than that in control group[85. 0%(34/40) vs 65. 0%(26/40)](P < 0. 05). Postoperative blood glucose level in observation group was significantly lower than that in control group[(5. 3 ± 1. 1) mmol/L vs( 6. 8 ± 1. 4) mmol/L]( P < 0. 05). Levels of Na^+,K^+ and Cl^- in observation group were higher than those in control group [(136. 9 ± 1. 0) mmol/L vs( 135. 6 ± 1. 1) mmol/L,(4. 1 ± 0. 5)mmol/L vs(3. 7 ± 0. 6)mmol/L,(102. 8 ± 2. 1)mmol/L vs(99. 8 ± 2. 4)mmol/L](all P < 0. 05).The first anal exhaust time in observation group was significantly shorter than that in control group[(29 ± 8) h vs(39 ± 12)h](P < 0. 05). Incidence of adverse reactions in observation group was significantly lower than that in control group[7. 5%( 3/40) vs 25. 0%( 10/40)]( P < 0. 05). Conclusion Mannitol combined with oral rehydration salts for intestinal preparation before radical mastectomy shows good intestinal cleaning effect,as well as can stabilize blood sugar and electrolytes,promote intest

关 键 词：乳腺癌根治术 甘露醇 口服补液盐 肠功能 肠道清洁程度 

分 类 号：R737.9[医药卫生—肿瘤]