厚朴排气合剂联合腹腔镜技术在老年人直肠癌加速康复外科中的应用研究

Effect of Houpu Exhaust mixture combined with laparoscopy on ERAS in elderly patients with rectal cancer

目的:探讨厚朴排气合剂联合腹腔镜技术在老年人直肠癌加速康复外科(ERAS)中的作用。方法:选取病例88例,根据随机数字表法分为两组。对照组采用腹腔镜技术施行手术,并予以ERAS干预;观察组在对照组的基础上加用厚朴排气合剂治疗。对比两组患者的胃肠功能恢复和住院时间、胃泌素(GAS)和胃动素(MTL)水平、炎症反应及术后腹胀情况。结果:观察组术后规律肠鸣音出现、初次排便、初次排气、初次进流食时间、住院时间均短于对照组,差异有统计学意义(P<0.05);术后,观察组GAS和MTL水平均高于对照组,白细胞、CRP、PCT水平均低于对照组,差异有统计学意义(P<0.05);观察组术后腹胀发生率(4.55%)明显低于对照组(18.18%),差异有统计学意义(P<0.05)。结论:在老年人直肠癌ERAS中采用厚朴排气合剂联合腹腔镜技术,可促进患者胃肠功能恢复,减少手术对患者胃肠激素的影响,减轻炎症反应,降低术后腹胀发生率。

Objective:To investigate the effect of Houpu exhaust mixture combined with laparoscopy in elderly patients with rectal cancer accelerated rehabilitation surgery(ERAS).Methods:88 elderly patients who received rectal cancer surgery were divided into two groups according to the random number table method.The control group was operated by laparoscopy and intervened by ERAS;The observation group was treated with Houpu exhaust mixture on the basis of the control group.The recovery of gastrointestinal function,length of stay,levels of gastrin(GAS)and motilin(MTL),inflammatory response and postoperative abdominal distention were compared between the two groups.Results:The time of regular bowel sounds,first defecation,first exhaust,first feeding and hospitalization in the observation group were shorter than those in the control group(P<0.05);After the operation,the levels of gas and MTL in the observation group were higher than those in the control group,and the levels of leukocyte,CRP and PCT were lower than those in the control group,the difference was statistically significant(P<0.05);The incidence of abdominal distention in the observation group(4.55%)was significantly lower than that in the control group(18.18%)(P<0.05).Conclusion:The combination of Houpu exhaust mixture and laparoscopy can promote the recovery of gastrointestinal function,reduce the impact of surgery on gastrointestinal hormones,reduce the inflammatory response,and reduce the incidence of postoperative abdominal distention.