胃肠综合训练对老年膀胱癌根治术后患者胃肠功能恢复的影响  

Training can promote the recovery of gastrointestinal function after radical cystectomy for elderly bladder cancer patients

作　　者：高俊平[1] 王静[2] 高凯霞[1] 贺美[1] 翟晓梅[1] 秦素芳[1] 双卫兵[1] Gao Junping;Wang Jing;Gao Kaixia;He Mei;Zhai Xiaomei;Qin Sufang;Shuang Weibing(Urological Surgery Department,First Hospital of Shanxi Medical University,Taiyuan 030001,China;North China University,Taiyuan 030051,China)

机构地区：[1]山西医科大学第一医院泌尿外科,太原030001 [2]中北大学英语系,太原030001

出　　处：《中华物理医学与康复杂志》2020年第11期1014-1017,共4页Chinese Journal of Physical Medicine and Rehabilitation

基　　金：山西省新型产业领军人才项目(晋人社厅函2020-587)。

摘　　要：目的:探讨胃肠综合训练对老年患者膀胱癌根治术后胃肠功能恢复的影响。方法:选取接受膀胱癌根治术Bricker术的老年患者71例,按照随机数字表法将其分为观察组(37例)和对照组(34例)。对照组采用常规治疗,观察组在对照组基础上,从术毕即刻开始给予胃肠综合训练,分时段分部位进行。术前、术后第1日、第3日抽血检测血浆胃泌素水平,记录患者肠鸣音恢复时间、首次排气及排便时间、肠梗阻发生率、平均住院日,术后第7日、14日、21日及28日采用胃肠道症状评定量表(GSRS)对2组患者的胃肠功能进行评分。结果:术前,2组患者血浆中胃泌素含量比较,差异无统计学意义(P>0.05)。与组内术前及对照组同时间点比较,观察组第1日[(348.35±55.36)ng/L]、第3日[(378.45±31.84)ng/L]的胃泌素含量较高(P<0.05)。与对照组比较,观察组术后肠鸣音恢复时间[(1.22±0.15)d]、首次排气时间[(1.88±0.22)d]、首次排便时间较短[(2.95±0.19)d],肠梗阻发生率(23.53%)较低(P<0.05)。与对照组比较,观察术后第7天[(68.46±10.24)分]、第14天[(47.19±10.93)分]、第21天[(24.51±9.81)分]、第28天[(14.49±7.52)分]的GSRS评分较低(P<0.05)。观察组患者的平均住院日[(12.79±4.52)d]少于对照组[(17.05±1.70)d],差异有统计学意义(P<0.05)。结论:老年膀胱癌根治术后患者进行胃肠综合训练,能够有效促进胃肠功能恢复。Objective To explore the effect of comprehensive gastrointestinal training on the recovery of gastrointestinal function after radical cystectomy(Bricker′s operation).Methods Seventy-one elderly bladder cancer patients who had undergone Bricker′s operation were randomly divided into a control group of 34 and an observation group of 37.Both groups were given routine treatment,while the observation group was additionally provided with comprehensive gastrointestinal training immediately after the operation.Plasma gastrin was measured before the operation and on the 1st and 3rd day afterward.The return of peristaltic sounds,the exhausting and defecation time,the incidence of intestinal obstruction and the average hospital stay were recorded.On the 7th,14th,21st and 28th day after the operation,both groups′gastrointestinal functioning was scored by using Gastrointestinal Symptom Rating Scale(GSRS).Results The levels of plasma gastrin in the observation group were significantly higher than before the surgery and significantly higher than those in the control group on the 1st and 3rd day after the surgery,though there had been no significant difference between the two groups before the operation.Compared with the control group,peristaltic sounds returned significantly earlier in the observation group(after 1.22±0.15d),and the group′s exhaust time(1.88±0.22d)and first defecation time(2.95±0.19d)were also better.The incidence of intestinal obstruction(23.53%)was significantly lower in the observation group as well.The observation group recorded lower average GSRS values than the control group throughout the observation and follow-up periods,and their average hospital stay was significantly shorter.Conclusion Comprehensive gastrointestinal training can effectively promote recovery after radical bladder cystectomy.

关 键 词：老年膀胱癌根治术 胃肠综合训练 胃肠功能恢复 

分 类 号：R737.14[医药卫生—肿瘤]