微米大黄炭白芨胶对结直肠癌ESD术后感染的防治效果观察  

Effect observation on the prevention and treatment of micron rhubarb charcoal and bletilla gel on postoperative infection of colorectal cancer Esd surgery

作　　者：张媛媛 王保振 ZHANG Yuanyuan;WANG Baozhen(Dept.of Critical Care Medicine,Kaifeng Cancer Hospital,Kaifeng 475000,China;Dept.of General Surgery,Kaifeng Cancer Hospital,Kaifeng 475000,China)

机构地区：[1]开封市肿瘤医院重症医学科,河南开封475000 [2]开封市肿瘤医院普外科,河南开封475000

出　　处：《华夏医学》2023年第6期135-139,共5页Acta Medicinae Sinica

基　　金：河南省医学科技攻关项目(LHGJ20200163)。

摘　　要：目的:观察微米大黄炭白芨胶辅助结直肠癌内镜下黏膜剥离术(ESD)对术后感染的防治效果。方法:选取90例行ESD治疗的结直肠癌患者,按照随机数字表法分为观察组和对照组,每组45例。对照组予以常规质子泵抑制剂(PPI)辅助ESD治疗,观察组采用微米大黄炭白芨胶辅助ESD治疗。比较两组治疗前后的凝血功能指标,胃液中生长因子表达水平,术后溃疡指数、溃疡愈合率及术后感染发生情况。结果:治疗后,观察组的凝血活酶时间(APTT)、凝血酶时间(TT)均短于对照组,凝血酶原时间国际标准化比值(PT-INR)小于对照组,血管内皮生长因子(VEGF)、表皮生长因子(EGF)、转化生长因子-β(TGF-β)的水平均高于对照组,差异有统计学意义(P<0.05)。观察组术后1周、术后4周的溃疡指数均低于对照组,溃疡愈合率均高于对照组(P<0.05)。观察组的术后感染发生率低于对照组(P<0.05)。结论:微米大黄炭白芨胶辅助ESD能有效改善结直肠癌患者的凝血功能及创面愈合情况,可降低术后感染发生的风险。Objective:To observe the preventive and therapeutic effects of micron rhubarb charcoal and bletilla glue assisted endoscopic submucosal dissection(ESD)for postoperative infection in colorectal cancer.Methods:90 colorectal cancer patients who underwent ESD surgery were randomly divided into the observation group and control group with 45 cases each.The control group were received conventional proton pump inhibitor(PPI)assisted ESD,while the observation group were received micron rhubarb charcoal and bletilla gel assisted ESD.The coagulation function indicators,growth factor expression levels in gastric juice,postoperative ulcer index,ulcer healing rate,and postoperative infection incidence of the two groups were compared before and after treatment.Results:After treatment,the APTT,TT,PT-INR,in the observation group were lower than those in the control group.VEGF,EGF,and TGF-βlevels were higher than those in the control group(P<0.05).The ulcer index of the observation group at 1 and 4 weeks after surgery was lower than that of the control group,and the ulcer healing rate was higher than that of the control group(P<0.05).During the follow-up period,the incidence of postoperative infection in the observation group was lower than that in the control group(P<0.05).Conclusion:Micron rhubarb charcoal and bletilla glue assisted ESD surgery can effectively improve the coagulation function and wound healing of colorectal cancer patients,and has a positive effect on reducing the risk of postoperative infection.

关 键 词：结直肠癌 内镜下黏膜剥离术 微米大黄炭白芨胶 创面愈合 术后感染 

分 类 号：R735.3[医药卫生—肿瘤]