莫沙必利联合氟西汀治疗结直肠癌患者术后胃肠功能障碍临床疗效

Curative Effect of Mosapride Combined with Fluoxetine on Postoperative Gastrointestinal Dysfunction of Colorectal Cancer Patients

关键词:  莫沙必利  氟西汀  结直肠癌  术后胃肠功能障碍

Key words:  mosapride  fluoxetine  colorectal cancer  postoperative gastrointestinal dysfunction

摘要:

目的 观察莫沙必利联合氟西汀治疗结直肠癌患者术后胃肠功能障碍的临床疗效。方法 收集2015年12月-2016年12月于直肠外科接受肠癌根治性手术且术后出现胃肠功能障碍的58例结直肠癌患者，随机分为3组：常规组（20例）进行基础护理，单独组（19例）在基础护理的基础上口服莫沙必利，联合组（19例）在单独组的治疗基础上加服氟西汀。观察并比较3组患者一般资料及治疗后胃肠功能的恢复情况（肠鸣音次数、首次排气排便时间及住院时间）、外周血肠激素（胃动素、生长抑素）水平变化、治疗前后抑郁自评分数变化及术后总体疗效。结果 术后3 d及5 d，与常规组比较，联合组肠鸣音次数明显升高（P<0.05，P<0.01），首次排气排便时间及住院时间均明显缩短（P<0.05），胃动素水平明显增加，而生长抑素水平显著降低（均P<0.05）。抑郁自评量表结果显示，治疗1周后联合组评分明显低于常规组及单独组（P<0.05）；3组患者术后总疗效比较有统计学意义，联合组有效率显著高于常规组及单独组（P<0.05）。结论 莫沙必利联合氟西汀可增加结直肠癌患者术后胃肠功能障碍的疗效，有效促进患者术后胃肠功能的恢复，并可缩短治疗周期。

Abstract:

OBJECTIVE To observe the clinical effect of mosapride combined with fluoxetine on postoperative gastrointestinal dysfunction (PGD) of colorectal cancer patients. METHODS Collected 58 PGD patients who were received radical operation for colorectal cancer from December 2015 to December 2016 and randomly divided into three groups:routine group(20 cases) treated with basic nurse, separate group(19 cases) treated with mosapride and basic nurse, combined group(19 cases) treated with fluoxetine on the basis of separate group's treatment. To observe and compare the recovery of gastrointestinal function (bowl sounds scores, first exhaust defecation time and length of stay), the level of gut hormone in peripheral blood[motilin (MTL) and somatostatin(SS)] and the change of self-rating depression score as well as the total efficacy of 3 groups. RESULTS On the 3rd and 5th day after operation, compared with the routine group, there were significantly increase of bowl sounds scores in the combined group(P<0.05, P<0.01); the first exhaust defecation time and length of stay distinctly shorter in combined group(P<0.05). The level of MTL significantly increased and SS decreased in combined group (P<0.05) after treated. The result of self-rating depression scale showed that the score of combined group were higher than the other two groups(P<0.05). There were statistical significance in total efficacy of the 3 groups, the total efficacy of combined group were better than the other two groups(P<0.05). CONCLUSION Mosapride combined with fluoxetine can improve the curative effect of postoperative gastrointestinal dysfunction in patients with colorectal cancer and can shorten the treatment period as well as promote the recovery of gastrointestinal function.