摘要
目的探讨直肠癌中医快速康复外科(CMERAS)在直肠癌手术中的应用价值。方法将90例直肠癌患者随机分为治疗组和对照组,每组45例。对照组予传统快速康复外科(ERAS)进行围手术期管理,治疗组予CMERAS进行围手术期管理。采用"云中医"视诊仪观察治疗过程中两组患者中医证型的变化情况,比较术中肠道清洁程度、术后肛门首次排气时间、术后住院时间、直接医疗费用及并发症的发生情况。结果①治疗前、术后第1天组间比较,脾虚证、阴虚证、气虚证、痰湿证、无证型人数差异无统计学意义(P>0.05);出院当天组间比较,治疗组脾虚证、阴虚证、气虚证、痰湿证人数少于对照组(P<0.05),无证型人数多于对照组(P<0.05)。②治疗组术中肠道清洁情况优于对照组(P<0.05),术后肛门首次排气时间早于对照组(P<0.05),术后住院时间短于对照组(P<0.05),直接医疗费用少于对照组(P<0.05)。③治疗组、对照组并发症发生率分别为4.4%、2.2%,差异无统计学意义(P>0.05)。结论与传统ERAS相比,CMERAS有利于改善直肠癌患者术后脾虚、气虚、痰湿、阴虚等病理状态,加速术后康复,缩短住院时间,减少医疗费用。
Objective To explore the application value of Chinese medicine in enhanced recovery after surgery(CMERAS) for rectal cancer surgery. Methods Ninety patients with rectal cancer were randomly divided into treatment group and control group with 45 cases in each group. The control group adopted enhanced recovery after surgery(ERAS) for perioperative management, while the treatment group adopted CMERAS for perioperative management. The changes of TCM syndromes of the two groups were observed by using "TCM online" visual diagnostic instrument during the treatment process, and the clean degree of intestines during the operation, the first time of anal exhaust after the operation, the hospitalization time after the operation, the direct medical expenses and the occurrence of complications were compared between the two groups. Results ①Before treatment and on the first day after operation, there was no significant difference in the number of spleen deficiency syndrome cases, yin deficiency syndrome cases, qi deficiency syndrome cases, phlegm dampness syndrome cases and non-syndrome cases identified by visual diagnostic instrument between two groups(P>0.05). On the day of discharge, the number of patients with spleen deficiency syndrome, yin deficiency syndrome, qi deficiency syndrome and phlegm-dampness syndrome in the treatment group was less than that in the control group(P<0.05), and the number of non-syndrome cases was more than that in the control group(P<0.05). ②Intraoperative clean degree of intestines in the treatment group was better than that in the control group(P<0.05), the first time of anal exhaust after operation was earlier in the treatment group than that in the control group(P<0.05), the postoperative hospitalization time was shorter in the treatment group than that in the control group(P<0.05), and the direct medical expenses in the treatment group were less than that in the control group(P<0.05).③The incidence of complications in the treatment group and the control group were 4.4% and 2.2% respec
作者
刘岗
杜磊
阎良
张熹玮
张浩
蒋海锋
孔宪诚
李财宝
汤雪峰
黄建平
LIU Gang;DU Lei;YAN Liang;ZHANG Xiwei;ZHANG Hao;JIANG Haifeng;KONG Xiancheng;LI Caibao;TANG Xuefeng;HUANG Jianping(Department of General Surgery,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200021,China)
出处
《上海中医药杂志》
2020年第7期69-72,共4页
Shanghai Journal of Traditional Chinese Medicine
基金
上海市卫计委进一步加快中医药事业发展三年行动计划项目[ZY(2018-2020)-ZYBZ-07]。
