| 摘要: |
| 目的：探讨术后早期经鼻空肠营养管鼻饲四磨汤对食管癌术后胃肠功能恢复的影响。方法：将80例食管癌手术患者分为研究组和对照组各40例，研究组术后6 h开始每隔8 h经鼻空肠营养管注入20 mL四磨汤，注药前后分别用10 mL温生理盐水冲管；对照组术后6 h开始，每隔8 h经鼻肠营养管注入40 mL温生理盐水。比较两组术后肠鸣音恢复时间、首次排气和排便时间以及腹胀、恶心、呕吐的发生率。于术前1 d（T0） 、术后1 d（T1） 、术后3 d（T2）及术后7 d（T3） 采血检测血清脑肠肽和胃肠激素水平变化情况。结果：研究组肠鸣音平均恢复时间为（24.8±4.1）h，首次排气时间为（32.6±3.9）h，首次排便时间为（46.6±6.8）h，均明显短于对照组的（29.1±4.2）h、（39.2±4.1）h、（58.2±7.1）h（P<0.05）；研究组腹胀、恶心和呕吐的发生率明显低于对照组（P<0.05）。血管活性肠肽、五羟色胺数值T0、T1、T2时两组无明显差异；T3时研究组较对照组明显减少（P<0.05）。血清脑腓肽、P物质数值T0、T1时两组无明显差异；T2、T3时研究组较对照组明显增多（P<0.05）。胃动素、胃泌素数值T0时两组对比无明显差异；T1时较T0增高，无统计学意义；T2、T3较T1又有增高，研究组数值较对照组明显增高（P<0.05）。GHRP、CRH数值T0时两组对比无明显差异；T1时较T0时下降，T2时较T1上升，并超过T0时的数值。T2、T3时GHRP研究组升高比对照组明显，CRH对照组较研究组增高明显（P<0.05）。结论：早期经鼻空肠营养管鼻饲四磨汤，可有效促进食管癌术后胃肠功能恢复，减轻并发症的发生。 |
| 关键词: 食管癌 四磨汤 胃肠功能 胃肠激素 |
| DOI：10.3969/j.issn.1007-6948.2019.03.009 |
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| 基金项目: |
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| Effect of Simo Decoction on Gastrointestinal Function after Operation of Esophageal Cancer |
| YAO Guang-huai, DENG Bin, SHI Qing-tong |
| Department of Gastroenterology, the Affiliated Hospital of Yangzhou University, Yangzhou (22500), China |
| Abstract: |
| Objective To investigate the effect of early postoperative nasal jejunal tube feeding with Simo Decoction on the recovery of gastrointestinal function after esophageal cancer operation Methods Eighty patients with esophageal cancer surgery were divided into study group and control group (n=40). The patients in study group were injected with 20 mL of Simo Decoction through the nasal jejunal feeding tube every 8 h after 6 h of operation, and 10 mL warm saline was used to flush the tube before and after injection. The patients in control group were injected with 40 mL warm saline every 8 h after operation. The recovery time of bowel sounds, first deflation and defecation time, and incidence of bloating, nausea, and vomiting were compared between the two groups. The levels of serum brain-gut peptide and gastrointestinal hormone were measured at 1 d before operation (T0), 1 d after operation (T1), 3 d after operation (T2) and 7 d after operation (T3). Results The average recovery time of bowel sounds in study group was (24.8±4.1) h, the first exhaust time was (32.6±3.9) h, and the first defecation time was (46.6±6.8) h, which were significantly shorter than those of the control group (29.1 ±4.2) h. (39.2 ±4.1) h, (58.2 ±7.1) h (P<0.05). The incidence of abdominal distension, nausea and vomiting in the study group was significantly lower than that in the control group (P<0.05). There were no significant differences between the two groups in the vasoactive intestinal peptide and serotonin values at T0, T1 and T2, and at T3 the study group was significantly lower than control group (P<0.05). There were no significant differences between the two groups in serum cerebral peptide and substance P at T0 and T1, and at T2 and T3 the indexes in study group were significantly increased compared with the control group (P<0.05). There was no significant difference in motilin and gastrin values between the two groups at T0, the indexes at T1 were higher than T0, and those at T2 and T3 were higher than T1, the value of study group was significantly higher than that of control group (P<0.05). There was no significant difference in GHRP and CRH values between the two groups at T0, the indexes at T1 decreased compared with T0, those at T2 increased compared with T1, and exceeded T0. The increase of GHRP at T2 and T3 in study group was significantly higher than that in control group, and the CRH in control group was significantly higher than that in study group (P<0.05). Conclusion Early nasal jejunal tube feeding with Simo Decoction can effectively promote the recovery of gastrointestinal function after esophageal cancer operation and reduce the occurrence of complications. |
| Key words: Esophageal cancer Simo Decoction gastrointestinal function gastrointestinal hormone |
