合并肝硬化的腹腔镜结直肠癌患者术后应用生长抑素的疗效研究

Effect of somatostatin on colorectal cancer patients with liver cirrhosis after laparoscopic surgery

目的对接受手术治疗的合并肝硬化的结直肠恶性肿瘤患者,通过对比观察生长抑素在术后的治疗反应,评价其总的临床疗效。方法选择2010年5月至2012年5月在饶平县人民医院接受腹腔镜下结直肠癌根治术且合并肝硬化的患者50例,采用双盲、随机的前瞻性研究方法,随机分为试验组和对照组,各25例,两组患者均接受结直肠肿瘤根治术,其中试验组术后3 h内予注射用生长抑素,分别记录两组患者术前的一般资料及术后腹腔引流及胃肠减压情况,记录腹腔引流管和胃管拔除的时间,重点监测术后两组患者肝功能变化情况。结果术后试验组患者的腹腔总引流量、总胃肠减压量较对照组明显减少,两组腹腔总引流量分别为(1 500±75)ml和(800±65)ml(t=32.265,P=0.008),总胃肠减压量分别为(2 000±100)ml和(900±60)ml(t=47.162,P=0.006)。试验组肛门排气所需时间少于对照组[(3.0±0.9)d vs(3.4±0.7)d,t=1.754,P<0.05],术后留置胃管的天数比对照组更短[(3.0±1.0)d vs(5.4±0.9)d,t=8.920,P<0.01]。试验组术后肝功能恶化发生2例,对照组发生12例,两组术后肝功能恶化率比较差异有统计学意义(8%vs 48%,χ~2=9.921,P=0.002)。两组术后并发症发生情况比较,差异有统计学意义(0 vs 20%,χ~2=5.556,P=0.018)。结论接受手术治疗的结直肠癌合并肝硬化患者,应用注射用生长抑素可以降低术后肝功能恶化的发生率,减少术后并发症的发生,从而降低高风险手术的死亡率,延长患者的生存期。

Objective To investigate the therapeutic effect of somatostatin on postoperative patients with colorectal cancer complicated by liver cirrhosis. Methods Fifty patients undergoing laparoscopic radical resection of colorectal carcinoma, combined with liver cirrhosis, were selected from Raoping People s Hospital between May 2010 and May 2012. The patients were divided into experimental group and control group. Drainage of abdominal cavity and gastrointestinal decompression were recorded, so as the duration of abdominal cavity drainage tube and nasogastric tube. Patients’ liver function before and after operation in the two groups were also monitored. Results Drainage of abdominal cavity and gastrointestinal decompression was significantly reduced in experimental group. Drainage of abdominal cavity was(800±65) ml in experimental group while it was(1 500±75) ml in control group(t=32.265,P=0.008). Drainage of gastrointestinal decompression was(900±60) ml and(2 000±100) ml(t=47.162, P=0.006) in experimental group and control group, respectively. Anal exhausting time was shorter in experimental group(t=1.754, P<0.05). Duration of nasogastric tube in the experimental group was less than the control group [(3.0±1.0) d vs(5.4±0.9) d, t=8.920, P<0.01]. Deterioration rate of liver function in experimental group was 8%(2/25), while it was 48%(12/25) in control group(χ2=9.921, P=0.002). Conclusion Application of somatostatin in patients with colorectal cancer complicated by liver cirrhosis is helpful to reduce the incidence of deterioration of liver function, and it may also reduce postoperative complications and lower the risk of operation mortality.