择期结直肠癌手术患者两种不同肠道准备方法的临床疗效比较

Clinical efficacy comparation of two different intestine preparation on patients with colorectal cancer underwent elective operation

目的探讨结直肠癌患者术前肠道准备中两种常用方法临床疗效的差异。方法选择2016年1月~2017年6月在西安交通大学第一附属医院普通外科因结直肠癌需行手术治疗的患者231例作为研究对象,按随机数字表法分为实验组(117例)和对照组(114例)。实验组术前予以复方聚乙二醇电解质散行肠道准备,对照组予以肥皂水灌肠行肠道准备,观察两组患者肠道清洁程度、不适程度、灌肠后血清炎性指标及电解质变化、术后肠功能恢复情况。结果两组患者术中肠道清洁程度评分、白细胞、血清钾离子和氯离子水平、术后肠功能恢复时间、排气时间、排便时间及腹腔感染发生情况比较,差异均无统计学意义(P>0.05)。实验组肠道准备过程中患者恶心、腹胀、腹痛发生率低于对照组,血清钠水平明显高于对照组,差异均有统计学意义(P<0.05)。结论 与传统肠道准备方法相比,口服复方聚乙二醇电解质散疗效肯定,并可降低患者的不适程度,降低电解质紊乱发生率,值得推广应用。

Object To explore the clinical efficacy of two methods commonly used in preoperative bowel preparation on patients with colorectal cancer. Methods From January 2016 to June 2017, 231 patients with colorectal cancer underwent surgical treatment in Department of General Surgery, the First Affiliated Hospital of Xi＇an Jiaotong University were selected and randomly divided into two groups according to the random number table, of which 117 cases in the experimental group and 114 cases in the control group. The experimental group was given compound polyethylene glycol electrolyte for intestinal preparation before operation, while the control group was given soapy water enema. The intestinal cleanliness score, patients＇ discomfort degree, serum inflammatory index and electrolytes changes, postoperative recovery of intestinal function were observed. Results There were no statistically significant differences in the intestinal cleanliness score, serum leukocyte level potassium and chloride level, postoperative recovery time of intestinal function,postoperative exhaust time, postoperative defecation time and incidence of abdominal infection（P〈0.05）. However, the incidence of nausea, abdominal distension or abdominal pain in the experimental group was lower than that of control group in the process of bowel preparation, the serum sodium level in the experimental group was significantly higher than that of control group, with statistically significant differences（P〈0.05）. Conclusion Compared with the traditional method of bowel preparation, oral administration with compound polyethylene glycol electrolyte has a more positive effect, and can reduce the degree of discomfort and the incidence of electrolyte imbalance, which is worth promotion and application.