肠功能恢复汤对前列腺癌术后肠道功能恢复的影响

Comparison of therapeutic effect of IFRD on postoperative intestinal function recovery in prostate cancer

目的:探讨术后使用肠功能恢复汤(intestine function recovery decoction,IFRD)对前列腺癌术后早期肠道功能恢复的影响。方法:回顾性分析西安交通大学第一附属医院泌尿外科2012年10月至2017年6月完成前列腺癌手术患者的临床病理资料,共计144例,根据术后是否进行了灌肠治疗及灌肠使用的方法分为未灌肠组、肥皂水组和IFRD组,对比研究三组患者术后恢复情况及差异。多因素Logistic(逐步法)回归进一步研究影响前列腺癌术后胃肠道功能恢复的危险因素。结果:一般基线资料比较显示三组患者之间无显著差异(P>0.05);Logistic多因素回归分析显示,手术方式、术前新辅助治疗、年龄大于65岁、术后合并症是影响术后胃肠道功能恢复的危险因素(P<0.05);术后情况比较显示,术后腹腔引流量、留置引流管时间以及术后住院时间IFRD组均显著优于其他两组(P<0.05);术后首次排便时间及饮水时间IFRD组均明显优于其他两组(P<0.05);与传统的灌肠剂肥皂水比较,IFRD组术后首次排便时间、引流量及引流时间分别为(3.24±1.51)d、(15.10±3.36)ml、(3.86±1.16)d,均明显低于肥皂水组(4.44±1.78)d、(23.38±17.20)ml、(4.51±2.11)d(P<0.05)。结论:根治性前列腺癌术后给予IFRD灌肠可显著减少腹腔引流量及引流管留置时间;可促进患者胃肠道功能的恢复以及缩短术后住院时间,有助于促进患者术后排气排便,降低术后近期并发症。

Objective：To observe the effectiveness of IFRD on gastrointestinal function in patients after prostatectomy.Methods：Retrospective analysis of 144 prostate cancer patients data from October 2012 to June 2017.The patients were divided into three groups：The sham group，the soapy water group and the IFRD group.Multivariate Logistic regression was used to further study the risk factors for the recovery of gastrointestinal function after prostate cancer.Results：The general baseline data showed no significant difference in three groups.Logistic multivariate regression analysis showed that the surgical approach，preoperative neoadjuvant therapy，age greater than 65 years，postoperative complications were the postoperative gastrointestinal function of the risk factors.Abdominal drainage volume，drainage tube time and postoperative hospital stay IFRD group were significantly better than the other two groups.Compared with the conventional soapy water，the first defecation time，drainage volume and drainage time were （3.24±1.51） d，（15.10±3.36） ml and （3.86±1.16） d respectively in the IFRD group，which were significantly lower than those in the soapy water group （4.44±1.78） d，（23.38±17.20） ml and （4.51±2.11） d.Conclusion：IFRD can significantly reduce the volume of peritoneal drainage and drainage tube retention time，beneficial to recovery of gastrointestinal function，shorten the postoperative hospital stay，promote exhaust defecation and reduce postoperative complications.