大黄、芒硝在壶腹周围癌术后的早期应用价值

Early Application Value of Rhubarb and Mirabilite in Postoperative Periampullary Carcinoma

目的探讨大黄、芒硝在壶腹周围恶性肿瘤行胰十二指肠切除术(pancreaticoduodenectomy,PD)患者中的早期应用价值。方法回顾性分析2020年1月一2021年12月在苏州大学附属第一医院普外科行PD的52例壶腹周围恶性肿瘤患者,其中,26例患者术后行大黄、芒硝外敷治疗(研究组),26例患者术后未接受大黄、芒硝外敷治疗(对照组)。研究组患者除常规治疗外,术后予以腹部外敷大黄、芒硝。比较两组患者的术后住院时间、首次排气/排便时间、尿管拔除时间、胃管拔除时间、肠内营养开始时间、半流质饮食开始时间以及并发症发生率。结果与对照组相比,研究组患者术后首次排气/排便时间较短、尿管拔除时间及胃管拔除时间较早,差异均有统计学意义(P<0.05)。与对照组相比,研究组患者术后肠内营养开始时间、半流质饮食开始时间较快,差异均有统计学意义(P<0.05)。与对照组相比,研究组术后住院时间较短,但差异无统计学意义(P>0.05)。与对照组相比,研究组患者术后B、C级胰瘘发生率较高、胃排空延迟发生率较低、腹腔脓肿发生率较高,但差异均无统计学意义(P>0.05)。结论大黄、芒硝外敷治疗能有效促进PD术后胃肠道功能恢复、尽早肠内营养,加快术后康复。

Objective To investigate the clinical application of rhubarb and mirabilite in patients with periampullary malignant tumor undergoing pancreaticoduodenectomy(PD).Methods From January 2020 to December 2021,52 patients with periampullary malignant tumor undergoing PD in General Surgery Department of First Affiliated Hospital of Soochow University were retrospectively analyzed:26 patients in study group and 26 patients in control group.In addition to routine treatment,the patients in the study group were given external application of rhubarb and mirabilite after operation.The length of postoperative hospital stay,first gassing/defecation time,urinary catheter removal time,gastric tube removal time,enteral nutrition start time,semi-liquid diet start time,and complication rates after PD were compared between the two groups.Results In the study group,earlier first exhaust time,earlier first defection time,shorter urinary catheter removal time and gastric tube removal time were observed(P<0.05).In the study group,faster enteral nutrition start time and semi-liquid diet start time were observed(P<0.05).No significant differences were observed in the length of postoperative hospital stay,the incidence of grade B and C pancreatic fistula,delayed gastric emptying and abdominal abscess between the study and control group(P>0.05).Conclusion External application of rhubarb and mirabilite can effectively promote the recovery of gastrointestinal function after PD,enteral nutrition as soon as possible,and accelerate postoperative recovery.