术前口服补液盐联合硫酸镁对老年乳腺癌根治术患者C-反应蛋白、GFV及预后的观察

Observation of preoperative oral rehydration salts combined with magnesium sulfate on C-reactive protein,GFV and prognosis of elderly breast cancer patients undergoing radical mastectomy

目的探讨术前口服补液盐联合硫酸镁对老年乳腺癌根治术患者C-反应蛋白(CPR)、胃内容物残留量(GFV)及预后的观察。方法选择2018年11月—2019年4月河北北方学院附属第一医院择期实施乳腺癌根治术的患者80例,按照随机数字表法将其分为联合组、硫酸镁液组,每组各40例。硫酸镁液组术前1 d 15∶00口服25%硫酸镁液50 mL。联合组术前1 d 15∶00口服25%硫酸镁液50 mL,17∶00口服补液盐,溶于300 mL温开水中,1 h内服完。统计两组术前1 d 8∶00(T1)和手术当日8∶00空腹时(T2)CRP水平和术前1 d 14∶00(T3)和术前1 d 23∶00时(T4)GFV;统计两组在给予硫酸镁液后至手术当日8∶00时排便次数以及术后排气时间和术后住院时间;采用视觉模拟评分法(VAS)统计两组入室静息状态(T5)、手术结束即刻(T6)和术后1 d(T7)时VAS评分,比较两组术后不良反应发生情况。结果与T1时点比较,两组T2时点CRP水平均降低,且T2时点联合组CRP水平低于硫酸镁液组,差异均有高度统计学意义(均P<0.01)。与T3时点比较,两组T4时点GFV均减少,且T4时点联合组低于硫酸镁液组,差异均有高度统计学意义(均P<0.01)。联合组排便次数高于硫酸镁液组,术后排气时间、术后住院时间短于硫酸镁液组及术后不良反应发生率低于硫酸镁液组,差异均有统计学意义(均P<0.05)。联合组于T7时VAS评分低于硫酸镁液组,差异有统计学意义(P<0.05)。结论术前口服补液盐联合硫酸镁可以降低老年乳腺癌根治术患者术前CRP水平和GFV,减少术后不良反应发生率,值得在临床中推广应用。

Objective To investigate the effect of preoperative oral rehydration salts combined with magnesium sulfate on C-reactive protein(CPR)and residual gastric fluid volume(GFV)and prognosis in elderly breast cancer patients undergoing radical mastectomy.Methods Eighty patients undergoing radical mastectomy in the First Affiliated Hospital of Hebei North University from November 2018 to April 2019 were selected and divided into the combined group and the magnesium sulfate solution group according to the random number table method,with 40 cases in each group.In the magnesium sulfate solution group,50 mL of 25%magnesium sulfate solution was taken orally at 15∶00 one day before operation.The combined group was given 50 mL of oral 25%magnesium sulfate solution at 15∶00 on one day before operation and oral rehydration salt at 17∶00,dissolved in 300 mL warm water,and was taken within one hour.The levels of CRP at 8∶00 on one day before operation(T1)and fasting at 8:00 on the day of operation(T2)were calculated,as well as GFV at 14∶00 on one day before operation(T3)and 23∶00 on one day before operation(T4).The times of defecation,postoperative exhaust time and postoperative hospital stay of the two groups were counted from 8∶00 on the day of operation after magnesium sulfate solution was given.Visual analogue scales(VAS)was used to calculate the VAS scores of the two groups at the room resting state(T5),immediately after surgery(T6)and one day affer surgery(T7).The occurrence of postoperative adverse reactions was compared between the two groups.Results Compared with T1 time point,the levels of CRP were decreased in both groups at T2 time point,and the combined group was lower than that in the magnesium sulfate solution group at T2 time point,the differences were highly statistically significant(all P<0.01).Compared with T3 time point,GFV in both groups was reduced at T4 time point,and the combined group was lower than magnesium sulfate solution group at T4 time point,the differences were highly statistically significant(all P<0.01).The times of defecation in the combined group was higher than that in the magnesium sulfate solution group,and the postoperative exhaust time and postoperative hospital stay were shorter than those in the magnesium sulfate solution group,and postoperative adverse reactions were lower than that in the magnesium sulfate solution group,with statistically significant differences(all P<0.05).VAS score in T7 of the combined group was lower than that of the magnesium sulfate solution group,and the difference was statistically significant(P<0.05).Conclusion Preoperative oral rehydration salts combined with magnesium sulfate can reduce the preoperative the levels of CRP and GFV in elderly breast cancer patients and reduce the incidence of postoperative adverse reactions,which is worthy of clinical application.