快速康复外科理念下针药联合对腹腔镜结直肠癌术后患者胃肠功能的影响

Effect of electroacupuncture and medicine combination on gastrointestinal function in patients with colorectal cancer after laparoscopic surgery based on the concept of enhanced recovery after surgery

目的探讨基于快速康复外科理念下电针联合吴茱萸热熨治疗对腹腔镜结直肠癌术后患者胃肠功能恢复的影响及其安全性。方法选取2019年10月—2020年12月在贵州省人民医院普外科住院治疗的60例结直肠癌患者为研究对象,随机分为观察组和对照组,每组30例。对照组围术期采用快速康复外科理念治疗,观察组在对照组的基础上予以电针双侧足三里、上巨虚穴及中药吴茱萸热熨神阙穴疗法干预。观察两组患者术后首次排气及排便时间、恢复半流质饮食时间、术后住院时间、腹痛评分、腹胀评分、常规生化指标以及术后并发症发生情况。结果与对照组相比,观察组术后首次排气时间、首次排便时间、恢复半流质饮食时间明显缩短(均P<0.05),术后腹痛缓解程度较高(P<0.05),第5天相关炎性指标均较低(均P<0.05),术后住院天数较少(P<0.05)。治疗期间两组患者均未发生吻合口漏等严重并发症及不良反应。结论在快速康复外科理念下电针联合吴茱萸热熨可促进腹腔镜结直肠癌术后患者胃肠功能更快恢复,缓解术后腹痛和炎症应激反应,且未增加术后并发症发生,可作为术后恢复胃肠功能的有效手段。

ObjectiveTo investigate the efficacy and safety of electroacupuncture(EA) combined with Evodia hot compresson on the recovery of gastrointestinal function in patients with colorectal cancer after laparoscopic surgery based on the enhanced recovery after surgery(ERAS).MethodsA total of 60 colorectal cancer patients who were hospitalized in the General Surgery Department of Guizhou Provincial People’s Hospital from October 2019 to December 2020 were selected and randomly divided into observation group and control group with 30 cases each.The control group was treated with the concept of ERAS during the perioperative period,and the observation group was additionally treated with EA at Zusanli and Shangjuxu acupuncture points plus Evodia hot compress Shenque acupuncture point compared to the control group.The first exhaust time,first defecation time,restore semi-liquid diet time,the time of hospitalization after operation,the abdominal pain score,the abdominal distention score,the inflammatory indicators and postoperative complications between two groups were observed.ResultsCompared to the control group,the observation group has significantly shorter first flatus time,first defecation time and recover semi-liquid diet time(all P<0.05),higher postoperative abdominal pain relief degree(P<0.05),lower related inflammatory indicators on the fifth day(all P<0.05),and less postoperative hospitalization days(P<0.05).During the treatment period,there were no serious complications and adverse reactions such as anastomotic leakage in the two groups.ConclusionsWith the concept of enhanced recovery after surgery,the electroacupuncture combined with Evodia hot compress can promote the recovery of gastrointestinal function in patients with colorectal cancer after laparoscopic surgery,and alleviate the symptoms of abdominal pain and inflammatory stress responses,without increasing the incidence of postoperative complications.It can be an effective means of postoperative gastrointestinal function recovery.