穴位注射新斯的明用于胃癌腹腔镜根治术后快速康复管理中的价值  

Value of Acupoint Injection of Neostigmine in the Rapid Recovery Management of Gastric Cancer Laparoscopic Radical Surgery

作　　者：张浩[1] 张熹玮[1] 蒋海锋[1] 刘岗[1] ZHANG Hao;ZHANG Xi-wei;JIANG Hai-feng(Shuguang Hospital,Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200021)

机构地区：[1]上海中医药大学附属曙光医院普外科,上海200021

出　　处：《医学临床研究》2023年第7期979-983,共5页Journal of Clinical Research

基　　金：上海市进一步加快中医药事业发展三年行动计划(中医优势病种培育建设项目)[编号:ZY(2018-2020)-ZYBZ-07]。

摘　　要：【目的】探讨穴位注射用于胃癌腹腔镜根治术后快速康复管理中的价值。【方法】将80例行胃癌腹腔镜根治术患者随机分为两组,每组40例,观察组在围术期行快速康复外科(FTS)管理的基础上加用足三里穴位注射新斯的明,对照组仅围术期实施FTS管理。比较两组手术相关指标,不同时点血清C反应蛋白(CRP)、白蛋白(ALB)水平及T淋巴细胞水平,比较两组不良反应发生情况和12个月生存情况。【结果】观察组下床活动时间、肛门排气时间、首次经口流质饮食时间、住院时间均显著少于对照组(P<0.05)。两组术后1 d、3 d的血清CRP水平显著高于术前,血清ALB水平显著低于术前(P<0.05);两组术后3 d血清CRP水平显著低于术后1 d,ALB水平显著高于术后1 d(P<0.05);观察组术后不同时点血清CRP水平显著低于对照组,血清ALB水平显著高于对照组(P<0.05)。两组术后3 d的CD3^(+)、CD4^(+)、CD8^(+)均显著低于本组术前(P<0.05);两组术后3 d的CD4^(+)/CD8^(+)与本组术前比较,差异均无统计学意义(P>0.05);观察组术后3 d的CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)均显著高于对照组(P<0.05)。观察组不良反应总发生率显著低于对照组(P<0.05)。两组患者术后12个月生存率比较,差异无统计学意义(P>0.05)。【结论】在采用FTS管理的基础上加用足三里穴位注射新斯的明有助于腹腔镜胃癌根治术后患者更快康复,减轻机体对刺激的应激反应,改善患者的营养状态,调控机体免疫功能,降低不良反应发生率。【Objective】To explore the value of acupoint injection of neostigmine in the rapid recovery management of patients undergoing gastric cancer laparoscopic radical surgery.【Methods】Eighty patients undergoing gastric cancer laparoscopic radical surgery were randomly divided into two groups,with 40 patients in each group.The observation group received acupoint injection of neostigmine in addition to Fast Track Surgery(FTS)management during the perioperative period,while the control group received only FTS management during the perioperative period.Surgical-related indicators,serum levels of C-reactive protein(CRP)and albumin(ALB)at different time points,T lymphocyte level,incidence of adverse reactions,and 12-month survival rate were compared between the two groups.【Results】The time of getting out of bed,the time of anal exhaust,the time of the first oral liquid diet,and the hospital stay in the observation group were significantly shorter than those in the control group(P<0.05).Compared to preoperative level,serum CRP level was significantly higher,while serum ALB level was significantly lower at 1 day and 3 days after surgery in both groups(P<0.05).The serum CRP level of the two groups at 3 days after surgery were significantly lower than those at 1 day after surgery,and ALB level at 3 days after surgery were significantly higher than those at 1 day after surgery in both groups(P<0.05).The observation group had significantly lower serum CRP level and significantly higher serum ALB level at different time points,if compared to the control group(P<0.05).CD3^(+),CD4^(+),and CD8^(+)levels at 3 days after surgery were significantly lower than preoperative level in both groups(P<0.05).The CD4^(+)/CD8^(+)at 3 days after surgery showed no significant difference compared to preoperative level in the same group(P>0.05).The levels of CD3^(+),CD4^(+),CD8^(+),and CD4^(+)/CD8^(+)at 3 days after surgery in the observation group were significantly higher than those in the control group(P<0.05).The incidence of adverse r

关 键 词：胃肿瘤/外科学 水针疗法 腹腔镜检查 新斯的明/治疗应用 

分 类 号：R735.2[医药卫生—肿瘤]