早期利尿联合加速康复外科理念对结、直肠癌患者术后恢复的影响

Effect of early diuretic combined with enhanced recovery after surgery on postoperative recovery of colon and rectal cancer patients

目的探讨早期使用利尿剂注射治疗联合加速康复外科(ERAS)对结、直肠癌择期手术后的影响。方法选取2017年1月~2018年12月山东省东营市东营区人民医院收治的214例接受结直、肠癌择期手术的患者,按随机数字表法将其分为干预组和对照组,每组各107例。干预组采用ERAS联合术后第1天和第2天给予静脉注射呋塞米10 mg,对照组单纯使用ERAS干预。比较两组患者术后住院时间、30 d内再入院率、排便时间、体重变化及并发症的发生率。结果两组患者术后住院时间、30 d内再入院率、体重变化比较,差异无统计学意义(P>0.05);干预组术后排便时间长于对照组,差异有统计学意义(P<0.05);两组患者术后急性肾功能损伤、低血钾、脓肿需要CT引流、伤口感染、重返手术、肠梗阻发生率比较,差异无统计学意义(P>0.05)。结论早期使用呋塞米利尿联合ERAS不利于促进结、直肠癌患者术后恢复。

Objective To investigate the effect of early diuretic injection therapy combined with enhanced recovery after surgery(ERAS)on colon and rectal cancer after elective surgery.Methods A total of 214 patients who received elective surgery for colon and rectal cancer from January 2017 to December 2018 in Dongying District People's Hospital of Dongying City in Shandong Province,were randomly divided into the intervention group and the control group according to the random number table method,with 107 patients in each group.The intervention group was treated with intravenous furosemide 10 mg on day 1 and day 2 after surgery and combined with ERAS,and the control group was treated with ERAS intervention alone.The hospital stay,readmission rate within 30 days,defecation time,weight change and incidence of complications were compared between the two groups after surgery.Results There was no statistically significant difference in length of hospital stay,readmission rate within 30 days,and weight change between the two groups after surgery(P>0.05).Defecation time in the intervention group after surgery was significantly longer than that in the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the incidence of acute renal injury,hypokalemia,CT drainage needed for abscess,wound infection,reentry surgery,and intestinal obstruction between the two groups after surgery(P>0.05).Conclusion Early use of furoxime diuretics combined with ERAS is not conducive to postoperative recovery of colon and rectal cancer patients.