不同洗肠药物用于肝癌术前肠道准备的安全性和有效性

The safety and efficacy of different preoperative intestinal preparations for patients with hepatocellular carcinoma

目的探讨肝癌术前不同洗肠药物的安全性和有效性。方法将120例肝细胞性肝癌患者随机分为A、B、C、D等4组,每组30例,分别采用25%硫酸镁(A组)、磷酸钠盐口服溶液(B组)、聚乙二醇电解质散(C组)和乳果糖口服溶液(D组)等4种药物口服洗肠,比较各组肠道清洁程度、肠功能恢复时间、药物口感、患者接受度和不良反应等发生情况。结果 4种药物的肠道清洁程度和术后肠功能恢复时间差异无统计学意义(P>0.05);B、C、D组药物口感和接受度显著优于A组,差异具有统计学意义(P<0.05);4组患者头晕、乏力、恶心和呕吐等不良反应比较,差异无统计学意义(P>0.05);腹痛、腹胀不良反应比较,差异具有统计学意义(P<0.05)。结论 4种药物在肠道清洁和术后肠功能恢复方面有较好的效果,PET-ELS和乳果糖具有口感良好、不良反应少和患者接受度高等特点,临床应用安全有效,在肝癌术前肠道准备方面具有良好的应用前景。

Objective To explore the safety and efficacy of different preoperative intestinal preparations for patients with hepatocellular carcinoma（HCC）.Methods A total of 120 HCC patients were divided randomly into four groups,each had 30 patients.Patients in group A were treated orally with 25% magnesium sulfate,in group B were treated orally with sodium phosphate,in group C were treated orally with polyethylene glycol-electrolyte lavage solution（PEG-ELS）,and in group D were treated orally with lactulose.The degree of intestinal cleaning,recovery time of bowel function,taste of the medications,acceptability of drug and rate of adverse effects were compared each other among the four groups.Results The degree of intestinal cleaning and recovery time of bowl function were not statistically deferent among the four groups（P〉0.05）.However,the taste and acceptability of drug were worse in 25% magnesium sulfate group than those in other three groups（P〈0.05）.The rates of adverse effects such as dizziness,fatigue,nausea and vomiting were not statistically different,while the rates of abdominal pain and distension were statistically different among the four groups（P〈0.05）.Conclusions The four drugs used for intestinal preparation have satisfactory effect on the degree of intestinal cleaning and recovery time of bowl function.PEG-ELS and lactulose are better concerning the nice taste,less adverse effects and higher acceptability,and therefore are worthy of clinical application.