生物多糖冲洗胶液联合术后中药保留灌肠预防直肠癌术后肠粘连的临床疗效评价

目的评价术中使用生物多糖冲洗胶液联合术后中药保留灌肠预防直肠癌术后肠粘连的临床疗效。方法将该科收集的2012年1月—2013年12月直肠癌切除术后、并且术后有明确病理诊断的48例直肠癌的患者随机分为治疗组28例和对照组20例。对照组采用术中肠壁及手术切口外擦医用几丁糖,术后营养支持,对症处理等治疗;治疗组采取术中关腹前腹腔注入生物多糖冲洗胶液,术后营养支持、中药保留灌肠等综合疗法。结果治疗组患者没有发生肠粘连,有效率为100%;对照组有1例发生肠粘连（不完全性肠梗阻）;1例发生完全性肠梗阻,在全麻下开腹行第二次肠粘连松解术,有效率为90%。结论术中使用生物多糖冲洗胶液联合术后中药保留灌肠预防直肠癌术后肠粘连的临床疗效确切,值得进一步做大样本的临床实验与观察;且医用几丁糖防术后粘连的临床疗效也值得进一步探讨。

CLINICAL EFFECT EVALUATION OF BIOLOGICAL POLYSACCHARIDE FLUSHING LIQUID COMBINED WITH POSTOPERATIVE RETENTION ENEMA WITH TRADITIONAL CHINESS MEDICINE ON THE PREVENTION OF POSTOPERATIVE INTESTINAL ADHESION

Objective To evaluate the clinical effect of intraoperative use of biological polysaccharide flushing liquid combined with postoperative retention enema with traditional Chinese medicine on the prevention of postoperative intestinal adhesion.Methods A total of 48 cases with rectal cancer who had revied rectal cancer resection and had definite pathological diagnosis after operation were enrolled in the author＇s hospital from January 2012 to December 2013,they were randomly divided into the treatment group of 28 cases and the control group of 20 cases.The control group was given intraoperative wall and the operation incision outside the rub of medical chitosan,postoperative nutritional support and symptomatic treatment.The treatment group adopted intraoperative intraperitoneal injection before abdominal closure biological polysaccharide flushing glue,postoperative nutritional support,retention enema with traditional Chinese medicine therapy.Results The patients in the treatment group had no intestinal adhesion,the effective rate was100%,while patients in the control group had 1 cases with intestinal adhesion（incomplete intestinal obstruction）,1 cases with complete intestinal obstruction,then second underwent enterolysis was given under the condition of general anesthesia,the efficiency was 90%.Conclusion The intraoperative use of biological polysaccharide flushing liquid combined with postoperative retention enema with traditional Chinese medicine can effectively prevent postoperative intestinal adhesion,it is worthy of the further clinical and experimental observations,the clinical curative effect and medical chitosan anti adhesion are also worthy of further study.