实用老年医学

实用老年医学 ›› 2022, Vol. 36 ›› Issue (3): 253-256.doi: 10.3969/j.issn.1003-9198.2022.03.010

• 临床研究 • 上一篇    下一篇

高龄结直肠肿瘤合并肠梗阻病人肠功能的预康复研究

龚冠闻, 成汇, 潘华峰, 刘江, 马坤, 程双, 王启飞, 江志伟   

  1. 210029 江苏省南京市,南京中医药大学附属医院(江苏省中医院)普外科
  • 收稿日期:2021-06-07 出版日期:2022-03-20 发布日期:2022-03-29
  • 通讯作者: 江志伟,Email:surgery34@163.com

Pre-rehabilitation of intestinal function in elderly patients with colorectal tumor complicated with intestinal obstruction

GONG Guan-wen, CHENG Hui, PAN Hua-feng, LIU Jiang, MA Kun, CHENG Shuang, WANG Qi-fei, JIANG Zhi-wei   

  1. Department of General Surgery, Affiliated Hospital of Nanjing University of Chinese Medicine (Jiangsu Province Hospital of Traditional Chinese Medicine), Nanjing 210029, China
  • Received:2021-06-07 Online:2022-03-20 Published:2022-03-29

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摘要： 目的 观察经肛型肠梗阻导管联合早期肠内营养治疗高龄结直肠肿瘤合并闭袢性肠梗阻病人的疗效。 方法 选取2018～2020年江苏省中医院普外科收治的结直肠肿瘤合并肠梗阻的高龄病人43例,分为治疗组(n=23)和对照组(n=20),其中治疗组采用经肛型肠梗阻导管减压联合早期肠内营养治疗;对照组采用禁食、肠外营养等常规治疗。2组保守5~7 d后手术。比较2组术后的炎症、营养、免疫指标,并比较2组微创手术成功率、一期吻合成功率、术后发热发生率、术后排气时间、术后住院天数、住院总费用等。 结果 治疗组的微创成功率、一期吻合成功率、术后排气时间、术后住院天数、住院总费用等指标均优于对照组(P<0.05或P<0.01),2组发热发生率差异无统计学意义(P>0.05)。治疗组术后炎症指标均低于对照组(P<0.05或P<0.01);治疗组白蛋白、转铁蛋白水平及CD3、CD4和CD8细胞计数高于对照组(P<0.05或P<0.01),CD4/CD8差异无统计学意义(P>0.05)。 结论 经肛型肠梗阻导管联合早期肠内营养治疗对肠功能起到了预康复作用,能有效改善病人的炎症、营养和免疫状况,减少并发症的发生,有利于高龄病人的恢复。

关键词: 经肛型肠梗阻导管, 早期肠内营养, 肠功能预康复

Abstract: Objective To observe the effect of transanal ileus tube combined with early enteral nutrition in the treatment of the elderly patients with colorectal cancer complicated with closed loop obstruction. Methods Forty-three patients with colorectal malignant tumor complicated with intestinal obstruction admitted to the Department of General Surgery of Jiangsu Province Hospital of Traditional Chinese Medicine from January 2018 to October 2020 were selected and divided into the treatment group (n=23) and the control group (n=20). The treatment group received transanal ileus tube decompression combined with early enteral nutrition. The control group received routine treatment such as fasting and parenteral nutrition. Both groups received operation after 5-7 days. The postoperative inflammation, nutrition and immune indexes, the rate of laparoscopic surgery, the rate of anastomosis, the postoperative fever rate, the time of first deflation, the postoperative hospital stay and the total hospitalization expense were compared between the two groups. Results In the treatment group, the rate of laparoscopic surgery, the rate of anastomosis, the time of first deflation, postoperative hospitalization day, total hospitalization expense were better than those in the control group (P<0.05 or P<0.01), and there was no statistical difference in fever rate between the two groups (P>0.05). The levels of postoperative inflammatory indexes in the treatment group were lower than those in the control group (P<0.05 or P<0.01). The levels of albumin and transferrin in the treatment group were higher than those in the control group (P<0.01). CD3, CD4 and CD8 cell counts in the treatment group were higher than those in the control group (P<0.05 or P<0.01), and there was no significant difference in CD4/CD8 (P>0.05). Conclusions The method adopted in this study has a pre-rehabilitation effect on intestinal function, and can effectively improve the inflammatory, nutritional and immune status of the patients, and reduce the complications, which is conducive to the recovery of patients.

Key words: transanal ileus tube, early enteral nutrition, pre-rehabilitation of intestinal function

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