术后大网膜包裹缓释化疗对肝癌患者术后恢复的影响
摘要
目的明确术后应用大网膜包裹氟尿嘧啶缓释剂进行缓释化疗对手术创伤状态下肝癌患者术后肠功能恢复及在院恢复质量的影响。方法选取2016年9月至2017年12月于该院肝胆外科住院并择期在全麻下开腹行肝肿瘤切除手术患者84例,根据术中是否在大网膜植入氟尿嘧啶缓释剂行术后缓释化疗分为术后化疗组(n=38)和非化疗组(n=46),应用40项恢复质量评分量表(QoR-40量表)评估两组患者术后在院期间的恢复质量,比较分析两组患者术后肠鸣音恢复时间、肛门排气时间、腹胀程度、术后住院时间及术后早期恢复质量等情况。结果术后化疗组患者的术后肠鸣音恢复时间,肛门排气时间及术后住院时间均较非化疗组延长(P<0.05);术后第3、5、7天腹胀程度亦较非化疗组患者表现更为明显(P<0.05)。在QoR-40量表评分中,术后化疗组患者术后第3、5、7天的身体舒适度、情绪状态、自理能力及恢复质量总评分明显低于非化疗组(P<0.01),经重复测量方差分析,其组间效应、时间效应及交互效应差异均具有统计学意义(P<0.01)。结论术后采用大网膜包裹缓释剂化疗会抑制肝癌手术患者肠功能恢复,增加患者术后腹胀,降低恢复质量,延长术后住院时间。
引文
[1]韩静.血浆microRNA用于肝癌早期诊断的分子流行病学研究[D].南京:南京医科大学,2015.
[2]殷香保,邬林泉,罗志强,等.肝癌术中丝裂霉素纤维蛋白胶局部缓释化疗的应用效果研究[J].中国全科医学,2013,16(12):1349-1352.
[3]刘旭斌,吴勇平,江红志,等.肝癌部分肝叶切除术后残肝断面植入5-氟尿嘧啶缓释剂对肝癌转移复发的影响[J].山西医药杂志,2015,44(14):1667-1669.
[4]GORNALL B F,MYLES P S,SMITH C L,et al.Measurement of quality of recovery using the QoR-40:aquantitative systematic review[J].Br J Anaesth,2013,111(2):161-169.
[5]KIM S Y,KIM J M,LEE J H,et al.Efficacy of intraoperative dexmedetomidine infusion on emergence agitation and quality of recovery after nasal surgery[J].Br J Anaesth,2013,111(2):222-228.
[6]KIM S H,OH Y J,PARK B W,et al.Effects of singledose dexmedetomidine on the quality of recovery after modified radical mastectomy:a randomised controlled trial[J].Minerva Anestesiol,2013,79(11):1248-1258.
[7]陈冰凝,章放香,张竞超,等.针刺对妇科腹腔镜术后患者早期恢复质量的影响:QoR-40量表[J].中华麻醉学杂志,2015,35(12):1428-1430.
[8]周述芝,宋丽,刘雪茹,等.右美托咪定对全身麻醉苏醒期躁动及术后恢复质量的影响[J].重庆医学,2014,43(36):4939-4941.
[9]雷秋林,吴毅欢,龚赞辉.右美托咪定对剖宫产术后恢复质量QoR-40的影响[J].福建医科大学学报,2017,51(1):58-60.
[10]谈振华,谢平,钱海,等.术前应用地塞米松改善腹腔镜胆囊切除患者的术后恢复质量[J].肝胆胰外科杂志,2013,25(5):416-418.
[11]翟明玉,黄祥,康芳,等.羟考酮对三叉神经微血管减压术患者术后早期恢复质量的影响[J].临床麻醉学杂志,2017,33(5):430-433.
[12]TANAKA Y,YOSHIMURA A,TAGAWA K,et al.Use of quality of recovery score(QoR40)in the assessment of postoperative recovery and evaluation of enhanced recovery after surgery protocols[J].J Anesth,2014,28(1):156-159.
[13]SASAKI K,TAMAKOSHI K.Association between the perspective of adult inpatients with digestive cancer regarding the nursing service and their quality of recovery on postoperative day 3[J].Nagoya J Med Sci,2018,80(1):29-37.
[14]MYLES P S,WEITKAMP B,JONES K,et al.Validity and reliability of a postoperative quality of recovery score:the QoR-40[J].Br J Anaesth,2000,84(1):11-15.
[15]HERRERA F J,WONG J,CHUNG F.A systematic review of postoperative recovery outcomes measurements after ambulatory surgery[J].Anesth Analg,2007,105(1):63-69.
[16]姜华,杨晋东.术前使用帕瑞昔布钠提高腹腔镜胆囊切除术患者的术后恢复质量[J].实用医院临床杂志,2017,14(5):101-103.
[2]殷香保,邬林泉,罗志强,等.肝癌术中丝裂霉素纤维蛋白胶局部缓释化疗的应用效果研究[J].中国全科医学,2013,16(12):1349-1352.
[3]刘旭斌,吴勇平,江红志,等.肝癌部分肝叶切除术后残肝断面植入5-氟尿嘧啶缓释剂对肝癌转移复发的影响[J].山西医药杂志,2015,44(14):1667-1669.
[4]GORNALL B F,MYLES P S,SMITH C L,et al.Measurement of quality of recovery using the QoR-40:aquantitative systematic review[J].Br J Anaesth,2013,111(2):161-169.
[5]KIM S Y,KIM J M,LEE J H,et al.Efficacy of intraoperative dexmedetomidine infusion on emergence agitation and quality of recovery after nasal surgery[J].Br J Anaesth,2013,111(2):222-228.
[6]KIM S H,OH Y J,PARK B W,et al.Effects of singledose dexmedetomidine on the quality of recovery after modified radical mastectomy:a randomised controlled trial[J].Minerva Anestesiol,2013,79(11):1248-1258.
[7]陈冰凝,章放香,张竞超,等.针刺对妇科腹腔镜术后患者早期恢复质量的影响:QoR-40量表[J].中华麻醉学杂志,2015,35(12):1428-1430.
[8]周述芝,宋丽,刘雪茹,等.右美托咪定对全身麻醉苏醒期躁动及术后恢复质量的影响[J].重庆医学,2014,43(36):4939-4941.
[9]雷秋林,吴毅欢,龚赞辉.右美托咪定对剖宫产术后恢复质量QoR-40的影响[J].福建医科大学学报,2017,51(1):58-60.
[10]谈振华,谢平,钱海,等.术前应用地塞米松改善腹腔镜胆囊切除患者的术后恢复质量[J].肝胆胰外科杂志,2013,25(5):416-418.
[11]翟明玉,黄祥,康芳,等.羟考酮对三叉神经微血管减压术患者术后早期恢复质量的影响[J].临床麻醉学杂志,2017,33(5):430-433.
[12]TANAKA Y,YOSHIMURA A,TAGAWA K,et al.Use of quality of recovery score(QoR40)in the assessment of postoperative recovery and evaluation of enhanced recovery after surgery protocols[J].J Anesth,2014,28(1):156-159.
[13]SASAKI K,TAMAKOSHI K.Association between the perspective of adult inpatients with digestive cancer regarding the nursing service and their quality of recovery on postoperative day 3[J].Nagoya J Med Sci,2018,80(1):29-37.
[14]MYLES P S,WEITKAMP B,JONES K,et al.Validity and reliability of a postoperative quality of recovery score:the QoR-40[J].Br J Anaesth,2000,84(1):11-15.
[15]HERRERA F J,WONG J,CHUNG F.A systematic review of postoperative recovery outcomes measurements after ambulatory surgery[J].Anesth Analg,2007,105(1):63-69.
[16]姜华,杨晋东.术前使用帕瑞昔布钠提高腹腔镜胆囊切除术患者的术后恢复质量[J].实用医院临床杂志,2017,14(5):101-103.