CAJ | 학술논문

目的：探讨大肠癌术后早期胃管拔出对患者血浆降钙素原变化及对胃肠功能恢复的影响。方法选取2010年2月至2014年8月西电集团医院普外科肿瘤科收治的大肠癌术后患者110例，采用随机数表法分为2组，其中研究组55例，予术后早期胃管拔出治疗，术后6 h 开始饮水，12 h 进流食，3 d 过渡到普通饮食；对照组55例，采取常规胃管拔出治疗，术后排气排便后拔出胃管，开始进食。比较术后及干预前后治疗前血浆降钙素原水平及术后并发症情况、术后排气排便时间、住院时间、住院费用等观察指标。结果（1）治疗后2组血浆降钙素原均明显下降，但二者相比差异无统计学意义（ P ＞0．05）；（2）治疗后，研究组排气时间（50．71±6．25）h 、排便时间（66．43±5．87）h 、住院时间（7．17±2．31）d 及住院费用（41562．87±274．36）元低于对照组（65．24±6．58）h 、（74．56±5．69）h 、（10．24±3．15）d 、（47893．57±314．82）元，差异有统计学意义（P＜0．05）；（3）治疗后，研究组并发症发生率（9．09％）与对照组（7．27％）相近，差异无统计学意义（P ＞0．05）。结论大肠癌术后早期胃管拔出有利于患者促进胃肠功能恢复，缩短住院时间，同时不影响降钙素原水平，不增加并发症发生风险，值得临床推广。
목적：탐토대장암술후조기위관발출대환자혈장강개소원변화급대위장공능회복적영향。방법선취2010년2월지2014년8월서전집단의원보외과종류과수치적대장암술후환자110례，채용수궤수표법분위2조，기중연구조55례，여술후조기위관발출치료，술후6 h 개시음수，12 h 진류식，3 d 과도도보통음식；대조조55례，채취상규위관발출치료，술후배기배편후발출위관，개시진식。비교술후급간예전후치료전혈장강개소원수평급술후병발증정황、술후배기배편시간、주원시간、주원비용등관찰지표。결과（1）치료후2조혈장강개소원균명현하강，단이자상비차이무통계학의의（ P ＞0．05）；（2）치료후，연구조배기시간（50．71±6．25）h 、배편시간（66．43±5．87）h 、주원시간（7．17±2．31）d 급주원비용（41562．87±274．36）원저우대조조（65．24±6．58）h 、（74．56±5．69）h 、（10．24±3．15）d 、（47893．57±314．82）원，차이유통계학의의（P＜0．05）；（3）치료후，연구조병발증발생솔（9．09％）여대조조（7．27％）상근，차이무통계학의의（P ＞0．05）。결론대장암술후조기위관발출유리우환자촉진위장공능회복，축단주원시간，동시불영향강개소원수평，불증가병발증발생풍험，치득림상추엄。
Objective To investigate the curative effect of early gastric tube extubation by observing the chan‐ges the plasma procalcitonin and gastrointestinal function in the colorectal cancer patients with early postoperative gastric tube extubation .Methods 110 postoperative patients with colorectal cancer admitted in the general depart‐ment of Xidian Group Hospital from February 2009 to August 2014 were selected and divided into 2 groups according to the random number table .The observation group(55 cases) was performed the early postoperative gastric tube ex‐tubation ,started to drink water at postoperative 6 h ,eat fluid diet at 12 h and transfered to the common diet on 3 d ;The control group(55 cases) adopted the conventional gastric tube extubation therapy ,pulled out the gastric tube ex‐tubation after postoperative exhaustion and defecation and then started to eat food .The plasma procalcitonin levels af‐ter operation ,before and after intervention were recorded ,meanwhile postoperative complications situation ,postopera‐tive exhaustion and defecation time ,hospital stay and hospital cost were recorded .Results (1)The plasma procalcito‐nin level after treatment in the two groups were significantly declined ,but the plasma procalcitonin level in the obser‐vation group was similar to that in the control group ,there was no statistically significant difference(P> 0 .05) ;(2) After treatment ,the exhaust time in the observation group was(50 .71 ± 6 .25)h ,defecation time was(66 .43 ± 5 .87) h ,length of hospital stay was(7 .17 ± 2 .31)d and hospitalization expenses were(41 562 .87 ± 274 .36)Yuan ,which were significantly lower than(65 .24 ± 6 .58 )h ,(74 .56 ± 5 .69)h ,(10 .24 ± 3 .15)d and(47 893 .57 ± 314 .82)Yuan in the control group ,the differences were statistically significant(P< 0 .05) ;(3)After treatment ,the occurrence rate of complications in the observation group was 9 .09% ,which was near 7 .27% in the control group ,showing no statisti‐cally significant difference(P> 0 .05) .Conclusion Early gastric tube extubation in the postoperative patients with colorectal cancer is conducive to promote the gastrointestinal function recovery and shorten the hospital stay without affecting the procalcitonin level and increasing the risk of complications occurrence ,which is worthy of clinical promo‐tion .