大承气汤保留灌肠联合腹腔热灌注化疗在腹腔镜胃癌术后的应用

Application of Dachengqi Decoction Retention Enema Combined with Hyperthermic Intraperitoneal Perfusion Chemotherapy in Laparoscopic Gastric Cancer Surgery

目的:观察大承气汤保留灌肠联合腹腔热灌注化疗(HIPEC)在腹腔镜胃癌术后的应用价值。方法:选取2020年3月-2022年4月宜春市人民医院收治的68例腹腔镜胃癌术患者,利用随机数字表法分为对照组、治疗组,各34例。对照组于腹腔镜术后进行HIPEC,治疗组在腹腔镜术后HIPEC基础上,联合大承气汤保留灌肠治疗。比较两组术后胃肠功能恢复时间及住院费用;于术后第1、7天,比较两组胃肠功能评分(症状自评量表评估)。结果:治疗组首次排气时间、排便时间、进食半流质时间及肠鸣音恢复时间均早于对照组,术后住院时间短于对照组,差异均有统计学意义(P<0.05);术后第1天,两组胃肠功能各条目评分比较,差异均无统计学意义(P>0.05);术后第7天,两组恶心呕吐、腹胀、腹痛、纳呆4个症状评分均较术后第1天显著下降,且治疗组术后第7天胃肠功能评分低于对照组,差异均有统计学意义(P<0.05)。结论:大承气汤保留灌肠联合HIPEC应用于腹腔镜胃癌术患者中,能够促进患者术后胃肠功能恢复,减轻胃肠功能不良反应症状,缩短住院时间。

Objective:To observe the application value of Dachengqi Decoction retention enema combined with hyperthermic intraperitoneal perfusion chemotherapy(HIPEC)in laparoscopic gastric cancer surgery.Method:From March 2020 to April 2022,68 patients with gastric cancer undergoing laparoscopic surgery in Yichun People's Hospital were selected and randomly divided into the control group and the treatment group,with 34 cases in each group.The control group was treated with HIPEC after laparoscopic surgery.The treatment group was treated with Dachengqi Decoction retention enema on the basis of HIPEC after laparoscopic surgery.The recovery time of gastrointestinal function and hospitalization cost were compared between the two groups.Gastrointestinal function scores were compared between the two groups on the 1st and 7th day after operation(assessed by Symptom Checklist).Result:The time of first exhaust,time of defecation,time to eat semiliquid,recovery time of bowel sounds in the treatment group were earlier than those in the control group,postoperative hospital stay in the treatment group was shorter than that in the control group(P<0.05).On the first day after operation,there were no significant differences in the scores of gastrointestinal function items between the two groups(P>0.05);on the 7th day after operation,the scores of nausea and vomiting,abdominal distension,abdominal pain and anorexia in the two groups were significantly lower than those on the 1st day after operation,and the gastrointestinal function scores in the treatment group were lower than those in the control group on the 7th day after operation,with statistical differences(P<0.05).Conclusion:Dachengqi Decoction retention enema combined with HIPEC can promote the recovery of gastrointestinal function of patients after laparoscopic gastric cancer surgery,reduce the adverse reaction symptoms of gastrointestinal function,and shorten the hospital stay.