摘要
目的探讨围手术期序贯处理对食管癌及贲门癌患者的术后影响。方法217例食管癌及贲门癌患者分为两组：对照组112例，全部患者行常规的围手术期治疗。实验组105例，术前1天全胃肠道灌洗，术后第1天开始肠内营养支持，维持5～7d。麻醉前1／2h静脉点滴抗生素1个单位，术后48h内停用抗生素。术前及术后第7天清晨测量体重，采血检测总蛋白（TP）、白蛋白（Alb），观察其手术前后的变化。术中观察肠道清洁状况，术后观察肛门排气恢复时间、术后并发症发生率及住院天数等。结果术后肛门排气恢复时间及术后住院天数，两组比较有显著性差异（P〈0.05）。术后并发症发生实验组较对照组少，且未发生吻合口瘘者。血清总蛋白、白蛋白及体重手术前后比较．对照组下降有显著性差异（P〈0．05），术后两组比较也有显著性差异（P〈0．05）。结论序贯的医疗措施，可使食管癌和贲门癌患者术后肠道功能恢复早，体重减轻、血清蛋白下降更少，减少术后并发症的发生，提高手术成功率。
Objective To investigate the effects of different perioperative treatment on nutritional status, resumption of gastrointestinal function and infectious complications in esophageal and cardiac carcinoma patients, Methods 217 patients with esophageal or cardiac carcinoma were randomized into two groups, 112 patients in the control group received routine treatment. The 105 patients in the experimental group accepted sequential perioperative treatment, which included the whole gastrointestinal lavage the day before operation, intravenous injection of antibiotics 30 minutes before anesthesia, lasting to 48 hours after operation, enteral nutritional support from 1st day to 5th or 7th day postoperatively. The level of total protein, albumin, and body weight were measured before and 7 days after surgical treatment. The intestinal clearance, resumption of gastrointestial function, complications after operation, and hospitalization were carefully observed. Results The time of resumption of gastrointestinal function and hospitalization were significantly decreased in the experimental group than （ P 〈 0.05 ）. 81% patients in the experimental group had Ⅰ degree of intestinal clearance, whereas 85% patients in the control group had Ⅲ degree of intestinal clearance. No patients in the experimental group had anastomotic leakage. In control group, the level of serum total protein, albumin and body weight were significantly decreased after operation （ P 〈 0.05 ）. Post - operative level of serum total protein, albumin and body weight was significantly lower in the control group than that in the experimental group. Conclusion Sequential medical treatment could result in earlier resumption of gastrointestinal function, less exhaustion of albumin and body weight and fewer complications in patients with esophageal or cardiac carcinoma receiving surgical treatment.
出处
《实用癌症杂志》
2008年第5期496-499,共4页
The Practical Journal of Cancer
关键词
食管癌
贲门癌
围手术期
全胃肠道灌洗
抗生素
Esophageal carcinoma
Cardiac carcinoma
Perioperation
Whole gastrointestinal lavage
Antibiotics
