术前大承气汤加味及肠内营养预适应对胃癌患者术后胃肠道功能恢复的影响  

The effect of Dachengqi Decoction and enteral nutrition on the recovery of gastrointestinal function in patients with gastric cancer

作　　者：李想[1] 张楠[1] 张静蕾 陈丽嫣 张鹤[1] 孙维义 Li Xiang;Zhang Nan;Zhang Jinglei;Chen Liyan;Zhang He;Sun Weiyi(Department of General Surgery,the First Affiliated Hospital of Henan University of Traditional Chinese Medicine,Zhengzhou 450003,China;Department of Clinical Medicine,Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]河南中医药大学第一附属医院普外二区,郑州450003 [2]郑州大学临床医学系,450000

出　　处：《中国实用护理杂志》2021年第1期44-48,共5页Chinese Journal of Practical Nursing

基　　金：河南省中医管理局国家中医临床研究基地科研专项项目(2018JDZX049)。

摘　　要：目的探讨术前大承气汤加味及肠内营养预适应对胃癌患者术后胃肠道功能恢复的影响。方法选取河南中医药大学第一附属医院2018年9月至2019年9月行胃癌根治术的100例患者作为研究对象。按随机数字表法分为观察组和对照组,每组各50例。对照组术前予以常规饮食,提供肠内营养液预适应;观察组在常规饮食的基础上加用大承气汤加味。观察并比较2组术后胃肠功能恢复状况、血浆胃动素(MTL)、血清胃泌素(GAS)含量、胃肠道并发症发生情况。结果手术治疗后对照组患者出现腹胀和腹泻者各3例,腹泻和恶心呕吐各1例,胃肠道并发症总发生率为16%(8/50),观察组出现腹胀和腹泻者各1例,胃肠道并发症总发生率为4%(2/50),2组比较差异有统计学意义(χ2值为4.000,P<0.05)。观察组患者术后首次肠鸣音出现时间、排气时间、排便时间分别为(26.12±5.32)、(25.49±4.49)、(32.63±4.31)h,对照组分别为(32.24±6.41)、(46.74±6.14)、(49.51±6.28)h,2组比较差异有统计学意义(t值为5.195、19.754、15.671,P<0.01)。术前观察组血浆MTL、血清GAS分别为(346.54±18.58)、(123.44±6.19)ng/L,术后分别为(247.24±11.40)、(85.46±5.12)ng/L,差异有统计学意义(t值为97.793、250.990,P<0.01)。术前对照组血浆MTL、血清GAS分别为(344.63±16.65)、(122.53±6.35)ng/L,术后分别为(205.84±10.21)、(64.79±5.24)ng/L,差异有统计学意义(t值为152.390、367.823,P<0.01)。术后2组比较差异有统计学意义(t值为19.129、19.950,P<0.01)。结论大承气汤加味及肠内营养液预适应有助于减少胃癌术后各种胃肠道并发症的发生,促进患者胃肠道功能快速康复,其可能与促进MTL、GAS的分泌相关。Objective To explore the effect of Dachengqi Decoction and enteral nutrition on the recovery of gastrointestinal function in patients with gastric cancer.Methods From September 2018 to September 2019,100 patients with gastric cancer undergoing radical gastrectomy in the First Affiliated Hospital of Henan University of Traditional Chinese Medicine were selected as the research objects,and were divided into observation group and control group according to the random number table method,each group contained 50 cases.Among them,the control group was given routine diet before operation to provide pre adaptation of enteral nutrient solution;the observation group was added with Dachengqi Decoction on the basis of routine diet.The recovery of gastrointestinal function,plasma motilin(MTL),serum gastrin(GAS)and gastrointestinal complications were observed and compared between the two groups.Results There were 3 cases of abdominal distention and diarrhea in the control group,1 case of diarrhea and 1 case of nausea and vomiting in the control group.The total incidence of gastrointestinal complications was 16%(8/50).There was 1 case of abdominal distention and 1 case of diarrhea in the observation group,and the total incidence of gastrointestinal complications was 4%(2/50).The difference between the two groups was statistically significant(χ^2 value was 4.000,P<0.05).In the observation group,the time of first bowel sounds,exhaust time and defecation time were(26.12±5.32)h,(25.49±4.49)h,(32.63±4.31)h,respectively,which were significantly shorter than those in the control group(32.24±6.41)h,(46.74±6.14)h,(49.51±6.28)h,and the difference was statistically significant(t value was 5.195,19.754,15.671,P<0.05).The plasma MTL and serum gas in the observation group were(346.54±18.58)ng/L,(123.44±6.19)ng/L.After operation,the results were(247.24±11.40)ng/L,(85.46±5.12)ng/L.The difference was statistically significant(t value was 97.793,250.990,P<0.05).The plasma MTL and serum gas of the control group before operation were(34

关 键 词：大承气汤 肠内营养 预适应 胃肿瘤 胃肠道功能 

分 类 号：R473.73[医药卫生—护理学]