针刺防治结直肠癌腹膜转移患者术后胃肠功能紊乱的临床疗效

Clinical Efficacy of Acupuncture in the Prevention and Treatment of Postoperative Gastrointestinal Dysfunction in Patients with Peritoneal Metastasis of Colorectal Cancer

目的:研究针刺防治结直肠癌腹膜转移患者术后胃肠功能紊乱的临床疗效。方法:选取2019年10月至2020年5月首都医科大学附属北京世纪坛医院收治的肿瘤细胞减灭术(CRS)术后的结直肠癌(Ⅳ期)腹膜转移术后患者73例作为研究对象,根据是否接受针刺分为对照组(n=32)和观察组(n=41),对照组仅采取西医围手术期治疗,观察组采用术后针刺治疗+西医围手术期治疗,比较2组患者首次自主排便时间、拔除胃管时间、胃管引流量、腹胀评分以及卡诺夫斯凯评分(KPS)。结果:观察组首次自主排便时间为(7.37±1.79)d,比对照组(8.97±2.55)d短,差异有统计学意义(P<0.05)。观察组拔除胃管时间为(6.07±1.35)d,比对照组(7.03±2.02)d短,差异有统计学意义(P<0.05)。术后3 d和术后7 d,2组患者术后胃管引流量差异均无统计学意义(P>0.05)。术后14 d,观察组腹胀评分为(1.17±0.714)分,比对照组腹胀评分低,差异有统计学意义(P<0.05)。2组患者于术前及术后1 d的KPS差异无统计学意义(P>0.05)。2组患者术后KPS评分均逐渐提高。术后14 d观察组评分(76.95±10.83)分比对照组(70.47±12.27)分高,差异有统计学意义(P<0.05)。结论:针刺治疗可以促进结直肠癌腹膜转移患者术后排便功能恢复,缩短拔胃管时间,改善腹胀症状和体力状态,具有积极的临床意义。

Objective:To investigate the clinical efficacy of acupuncture in the prevention and treatment of postoperative gastrointestinal dysfunction in patients with peritoneal metastasis of colorectal cancer.Methods:Seventy-three colorectal cancer(stageⅣ)peritoneal metastasis patients with gastrointestinal dysfunction after cytoreductive surgery(CRS)in Beijing Shijitan Hospital affiliated with Capital Medical University from October 2019 to May 2020 were enrolled in this study and divided into a control group(n=32)and an observation group(n=41)according to the presence of acupuncture treatment.The patients in the control group received perioperative therapy,while those in the observation group received acupuncture and perioperative therapy.The first voluntary defecation time,gastric extubation time,gastric drainage volume,abdominal distension score,and Karnofsky Performance Status Scale(KPS)score were compared between the two groups.Results:The first voluntary defecation time in the observation group was(7.37±1.79)days,which was shorter than(8.97±2.55)days in the control group(P<0.05).The gastric extubation time in the observation group was(6.07±1.35)days,which was shorter than(7.03±2.02)days in the control group(P<0.05).There was no significant difference in postoperative gastric drainage volume between the two groups 3 and 7 days after operation(P>0.05).Fourteen days after operation,the abdominal distension score of the observation group was(1.17±0.714),which was lower than that of the control group(P<0.05).There was no significant difference in KPS score between the two groups before operation and 1 day after operation(P>0.05).The KPS scores of the two groups were gradually improved after operation.The KPS score of the observation group was(76.95±10.83)points,higher than(70.47±12.27)points of the control group 14 days after operation(P<0.05).Conclusion:Acupuncture can promote postoperative recovery of defecation function in patients with colorectal cancer peritoneal metastasis,shorten gastric extubation time,and improve abdominal distension symptoms and physical state,with positive clinical significance.