摘要
目的比较选择性结直肠手术前 3d肠道准备方法中分别采用磷酸钠和硫酸镁及术前1d肠道准备中采用磷酸钠三者的清肠效果、术后并发症以及对肠道细菌的影响。方法将 2 0 0 0年1月至 2 0 0 0年 9月我科收治的 90例大肠癌患者分为 3组 ,每组 30例。 3d准备法施行 3d的饮食和口服抗生素准备 ,其中A组术前 1d下午口服 2 5 %硫酸镁清肠液 2 0 0ml+5 %葡萄糖盐水 15 0 0ml;B组口服 13 2 %磷酸钠口服清肠液 2 5 0ml+5 %葡萄糖盐水 10 0 0ml;C组只行 1d的饮食和抗生素准备 ,口服磷酸钠用法同B组。手术准备前后测体重 ,术中观察肠道清洁程度 ,取肠液、门静脉系统血液检测需氧菌、厌氧菌情况 ,观察术后并发症。结果手术准备前后A、B两组体重下降程度较C组显著 (P <0 0 5 ) ,3组清肠优、良率分别为 86 7%、96 7%、86 7% (P >0 0 5 ) ,A组肠液和血培养阳性率均高于B、C组 (P >0 0 5 ) ,A组术后并发症发生率 (2 0 % )高于B组 (10 % )和C组 (13 3% ) ,但差异无显著意义 (P >0 0 5 )。结论磷酸钠用于术前肠道准备优于硫酸镁 ,选择性结直肠手术前应用磷酸钠施行一日准备是一种可行。
Objective To investigate the effect of three bowel preparation protocols for elective colorectal surgery.MethodsFrom Jan. 2000 to Sep. 2000, 90 consecutive patients suffering from colorectal cancer admitted for elective colorectal surgery were divided into three groups:group A,the patients started low-residue diet and oral antibiotics 3 days before operation and received magnesium sulfate (MgSO 4) lavage solution the afternoon before operation. In group B, MgSO 4 was substituted by sodium phosphate (NaP) for the lavage. In group C,low-residue diet and oral antibiotics started the day before operation plus lavage by NaP as that in group B.The MgSO 4 lavage solution consisted of 200?ml of 25% MgSO 4 and 1.5?L of 5% glucose in normal saline (GNS), NaP lavage solution contains 250?ml of 13.2% NaP and 1?L of 5% GNS. Before and after bowel preparation all patients were weighed. Quality of colon cleansing was estimated in operation.The bowel juice and the portal veinous blood were sampled for culture and the postoperative complications were observed.ResultsThe body weight decreased significantly in patients from group A and B compared with group C (P<0.05). Good or excellent bowel preparation were achieved in 86.7% in group A, 96.7% in group B, and 86.7% in group C (P>0.05).There were more positive cultures from bowel juice and the portal veinous blood in group A (P>0.05). Rates of complications were 20% for group A,10% for group B and 13.3% for group C,respectively (P>0.05). Conclusion The oral sodium phosphate preparation is superior to magnesium sulfate before colorectal surgery. Single-day preoperative bowel preparation with oral sodium phosphate is suitable for elective colorectal surgery.
出处
《中华普通外科杂志》
CSCD
北大核心
2002年第2期69-71,共3页
Chinese Journal of General Surgery
