新斯的明联合芒硝外敷及排便训练用于结直肠癌术后肠功能恢复的价值研究  

Study on the value of neostigmine combined with mirabilite external application and defecation training in intestinal function recovery after colorectal cancer surgery

作　　者：吉晶晶 杨红生 颜海华 戴敏 Ji Jingjing;Yang Hongsheng;Yan Haihua;et al(Department of General Surgery,Hai'an People's Hospital,Jiangsu 226600,China)

机构地区：[1]海安市人民医院普外科,海安226600

出　　处：《中华保健医学杂志》2025年第1期151-155,共5页Chinese Journal of Health Care and Medicine

基　　金：南通大学临床医学专项项目(2022JY002)。

摘　　要：目的探讨新斯的明联合芒硝外敷及排便训练用于结直肠癌根治术后患者肠功能恢复的价值。方法前瞻性选取2020年1月~2023年12月于海安市人民医院就诊的102例结直肠癌根治术后患者,采用随机数表法分为观察组和对照组,各51例。对照组患者术后给予芒硝腹部外敷联合排便训练进行干预,观察组患者在对照组的基础上联合新斯的明进行治疗。比较两组患者的炎症因子指标[白细胞介素-6(IL-6)、白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)]、肠道黏膜屏障功能相关指标[D-乳酸(D-LA)、二胺氧化酶(DAO)]、T淋巴细胞亚群(CD3^(+)、CD4^(+)、CD4^(+)∕CD8^(+))、胃肠道症状分级量表(GSRS)评分及Wexner评分。结果治疗后,两组患者的IL-6、IL-1β和TNF-α水平均低于本组治疗前,且观察组患者的IL-6、IL-1β和TNF-α水平均低于对照组患者[(38.57±6.37)pg∕ml vs.(43.72±7.95)pg∕ml、(38.06±7.92)pg∕ml vs.(45.36±8.25)pg∕ml,(18.49±5.52)pg∕L vs.(24.96±6.72)pg∕L],差异均有统计学意义(t=3.610、4.559、5.313,P<0.05)。治疗后,两组患者血清D-LA、DAO水平均低于本组治疗前,且观察组患者血清D-LA、DAO水平均低于对照组患者[(3.28±0.42)mmol∕L vs.(4.51±0.63)mmol∕L、(3.86±0.55)IU∕ml vs.(5.14±0.62)IU∕ml],差异均有统计学意义(t=11.601、11.029,P<0.05)。治疗后,两组患者的CD3^(+)水平、CD4^(+)水平、CD4^(+)∕CD8^(+)均高于治疗前,且观察组患者的CD3^(+)水平、CD4^(+)水平、CD4^(+)∕CD8^(+)均高于对照组患者[(67.25±6.23)%vs.(61.94±5.86)%、(42.81±4.29)%vs.(39.14±3.51)%、(1.82±0.26)vs.(1.54±0.22)],差异均有统计学意义(t=4.434、4.728、5.871,P<0.05)。治疗后,两组患者的GSRS、Wexner评分均低于本组治疗前,且观察组患者的GSRS、Wexner评分均低于对照组患者[(15.41±1.06)分vs.(17.09±1.83)分、(7.12±2.06)分vs.(9.37±2.25)分],差异均有统计学意义(t=5.673、5.267,P<0.05)。结论新斯的明联合芒硝外�Objective To study the value of neostigmine combined with mirabilite external application and defecation training for intestinal function recovery in patients with colorectal cancer after radical surgery.Methods A prospective selection was made from 102 postoperative patients with colorectal cancer at Hai'an People's Hospital from January 2020 to December 2023.They were randomly divided into an observation group and a control group using a random number table method.After operation,51 patients in the control group were given abdominal application of glauber nitrate combined with defecation training intervention,while 51 patients in the observation group received additional treatment with neostigmine.Compare inflammatory cytokine indicators between two groups[interleukin-6(IL-6),interleukin-1β(IL-1β)、Tumor necrosis factor-α(TNF-α)]、Gut mucosal barrier function related indicators[D-lactate(D-LA),diamine oxidase(DAO)],T lymphocyte subsets(CD3^(+),CD4^(+),CD4^(+)∕CD8^(+)),Gastrointestinal Symptom Rating Scale(GSRS)score,and Wexner scores.Results After treatment,serum levels of IL-6,IL-1βand TNF-αin 2 groups were lower than before treatment.The observation group was lower than the control group[(38.57±6.37)pg∕ml vs.(43.72±7.95)pg∕ml,(38.06±7.92)pg∕ml vs.(45.36±8.25)pg∕ml,(18.49±5.52)pg∕L vs.(24.96±6.72)pg∕L],the difference was statistically significant(t=3.610,4.559,5.313,P<0.05).After treatment,serum D-LA and DAO levels in 2 groups were lower than before treatment,and the observation group was lower than the control group[(3.28±0.42)mmol∕L vs(4.51±0.63)mmol∕L,(3.86±0.55)IU∕ml vs(5.14±0.62)IU∕ml].The difference was statistically significant(t=11.601,11.029,P<0.05).After treatment,CD3^(+),CD4^(+)and CD4^(+)∕CD8^(+)in both groups were higher than before treatment.The observation group was higher than the control group[(67.25±6.23)%vs(61.94±5.86)%,(42.81±4.29)%vs(39.14±3.51)%,(1.82±0.26)vs(1.54±0.22)].The difference was statistically significant(t=4.434,4.728,5.871,P<0.05

关 键 词：结直肠癌根治术 新斯的明 芒硝 排便训练 肠道黏膜屏障功能 

分 类 号：R735.3[医药卫生—肿瘤]