香砂六君子汤在微创食管癌切除术后肠功能恢复中的应用效果

Application Effect of Xiangsha Liujunzi Decoction in Recovery of Bowel Function After Minimally Invasive Esophageal Cancer Resection

目的探讨香砂六君子汤在微创食管癌切除术后患者肠功能恢复中的应用。方法选取我院胸外科2018年1月~2019年12月行微创食管癌切除术的54例患者,按照随机数字表法分为对照组及观察组,每组27例。两组患者术后均给予静脉营养支持、补液、对症等常规治疗,对照组术后24 h开始给予生理盐水100 ml Bid管喂,观察组术后24 h开始辨证给予香砂六君子汤100 ml Bid管喂,比较两组肠功能恢复情况(术后肠鸣音恢复时间、肛门排气时间、排便时间及胃管拔除时间)、临床指标(住院时间、住院费用)及并发症发生情况。结果观察组肠鸣音恢复时间、肛门首次排气时间、首次排便时间短于对照组,胃管拔除时间早于对照组,差异有统计学意义(P<0.05)。观察组术后住院时间短于对照组,差异有统计学意义(P<0.05);两组住院费用比较,差异无统计学意义(P>0.05)。两组术后瘘、肺部并发症及吻合口狭窄发生率比较,差异无统计学意义(P>0.05)。结论在微创切除食管癌患者中,术后早期给予香砂六君子汤管喂能更快恢复肠功能,有助于患者康复,缩短住院时间,且不增加住院费用,经济实用。

Objective To explore the application of Xiangsha Liujunzi Decoction in the recovery of intestinal function in patients after minimally invasive esophageal cancer resection.Methods A total of 54 patients who underwent minimally invasive esophageal cancer resection in the Department of Thoracic Surgery in our hospital from January 2018 to December 2019 were selected and divided into the control group and the observation group according to the random number table method,with 27 cases in each group.Both groups of patients were given routine treatments such as intravenous nutritional support,fluid rehydration,and symptomatic treatment.The control group was given normal saline 100 ml Bid tube 24 h after surgery.The observation group was given Xiangsha Liujunzi Decoction with 100 ml Bid tube 24 h after operation.The recovery of bowel function(postoperative bowel sound recovery time,anal exhaust time,defecation time and gastric tube removal time),clinical indicators(hospitalization time,hospitalization expenses)and complications were compared between the two groups.Results In the observation group,the recovery time of bowel sounds,the time of first exhausting from the anus,and the time of first defecation were shorter than those in the control group and earlier than the control group,the difference was statistically significant(P<0.05).The postoperative hospital stay in the observation group was shorter than that in the control group,the difference was statistically significant(P<0.05);There was no significant difference in hospitalization expenses between the two groups(P>0.05).There was no significant difference in the incidence of postoperative fistula,pulmonary complications and anastomotic stenosis between the two groups(P>0.05).Conclusion In patients with minimally invasive resection of esophageal cancer,early postoperative administration of Xiangsha Liujunzi Decoction tube can restore intestinal function faster,help patients recover,shorten the length of hospitalization,and does not increase hospitalization costs,which is economical and practical.