莪黄灌肠液治疗直肠癌术后吻合口炎67例

Treatment of 67 Cases of Anastomotic Stomatitis after Rectal Cancer Operation with Curcumol Enema

目的观察莪黄灌肠液(经直肠灌注)对直肠癌患者术后吻合口炎的疗效以及对吻合口处具核梭杆菌生存情况的影响。方法根据标准选择我院肿瘤外科自2015年10月~2017年10月行手术治疗的直肠癌患者共计67例,经乙状结肠镜检查,明确吻合口炎诊断的患者,予莪黄灌肠液直肠灌注,治疗14d后通过复查乙状结肠镜来观察吻合口炎变化情况及患者腹泻、便秘、肛门下坠、排便肛门疼痛感、大便隐血症状是否改善;治疗前后,经肛镜下取吻合部样本、培养,对比吻合口处具核梭杆菌感染情况。结果莪黄灌肠液经直肠灌注14d后复查乙状结肠镜,临床痊愈9例(13.4%),疗效显著16例(23.9%),有效36例(53.7%),无效6例(8.9%),近期有效率高达91.0%;治疗前具核梭杆菌(FN)感染率67.16%(45/67),治疗14d后FN感染率28.35%(19/67),治疗前后比较p﹤0.01。结论莪黄灌肠液经直肠灌注治疗对直肠癌术后吻合口炎疗效满意,且能显著改善患者术后不适感并减轻局部具核梭杆菌感染率,值得在临床广泛应用。

Objective：To observe the effect of curcumol enema（transrectal perfusion） on postoperative anastomotic stomatitis in patients with rectal cancer and the effect on the survival of Fusarium oxysporum at the anastomosis.Method：67 patients with rectal cancer who underwent surgical treatment in the tumor surgery department from October 2015 to October 2017 were selected according to the standard.After sigmoidoscopy,the patients diagnosed as anastomotic stomatitis were given rectal perfusion of curcumol enema.After 14 days of treatment,the changes of anastomotic stomatitis,the improvement of diarrhea,constipation,anal fall,anal pain of bowel movement,and symptoms of fecal occult blood were observed by sigmoidoscopy.Before and after treatment,samples of anastomotic sites are taken and cultured under anus microscope to compare the infection of fusobacterium nucleatum（FN） at anastomotic sites.Result： After 14 days of rectal perfusion,9 cases（13.4%） were cured,16 cases（23.9%） remarkably effective,36 cases（53.7%） effective,6 cases（8.9%） ineffective,the short-term effective rate was 91.0%; the infection rate of FN before and after treatment were 67.16%（45/67） and28.35%（19/67）,with P〈0.01 before and after treatment.Conclusion： Curcumol enema（transrectal perfusion） on postoperative anastomotic stomatitis in patients with rectal cancer has satisfactory effect,and can significantly improve postoperative discomfort and reduce the local infection rate of FN.It is worthy of wide clinical application.