摘要
目的探讨氟哌噻吨美利曲辛在老年胃肠道恶性肿瘤患者围手术期中应用的安全性、可行性及有效性。方法采用随机双盲设计,将102例行手术治疗的老年胃肠道恶性肿瘤患者分为两组。研究组51例患者,术前3天至术后1周口服/鼻饲氟哌噻吨美利曲辛(1片,每日1次);对照组51例患者,予以安慰剂口服/鼻饲。术前1天及术后第1、3、5天采用汉密尔顿焦虑量表(HAMA)评估患者焦虑状态;记录分析患者术后恢复情况;术后1周、2周及1个月随访记录患者预后营养指数(PNI)及药物不良反应发生情况。结果研究组术后肠功能恢复时间、首次进食流质时间均早于对照组(P<0.05);术后5天内下床活动总时间较对照组显著延长(P<0.001),术后腹腔引流液总量显著少于对照组(P<0.001);术后第1、4、7天,研究组外周血C反应蛋白(CRP)低于对照组,但差异无统计学意义(P>0.05)。研究组术后总体并发症发生率显著低于对照组(P=0.007)。研究组术前1天及术后第1、3、5天HAMA评分均低于对照组(P<0.001)。术后第4、7天研究组外周血前白蛋白水平均高于对照组(P<0.05)。术后1周、2周及1个月研究组PNI显著高于对照组(P<0.05),术后1周、2周及1个月氟哌噻吨美利曲辛与安慰剂不良反应发生率的差异无统计学意义(P>0.05)。结论老年胃肠道恶性肿瘤患者围手术期使用氟哌噻吨美利曲辛安全有效,能够有效缓解老年焦虑、抑郁,一定程度上可促进患者术后康复。
Objective To comprehensively evaluate the safety,feasibility,and efficacy of flupentixol and melitracen during the perioperative management of elderly patients with gastrointestinal malignancies.Methods In this randomized double-blind study,102 elderly patients with gastrointestinal malignant tumors undergoing surgical treatment were divided into two groups.Fifty-one patients in the study group were given oral or nasogastric feeding flupentixol and melitracen one tablet daily from 3 days before surgery to 1 week after surgery,and 51 patients in the control group were given oral or nasogastric feeding placebo.Hamilton anxiety scale(HAMA)was used to evaluate the anxiety status of patients on the 1st day before operation and 1st,3rd and 5th days after operation.The postoperative recovery was recorded and analyzed.The patients were followed up at 1 week,2 weeks and 1 month after surgery to record the nutritional prognosis index(PNI)and the symptoms related to adverse drug reactions.Results The recovery time of intestinal function and the time of first liquid intake in the study group were earlier than those in the control group(P<0.05).The time of getting out of bed within 5 days after surgery in the study group was significantly longer than that in the control group(P<0.001).The amount of postoperative abdominal drainage fluid in the study group was significantly less than that in the control group(P<0.001).On the 1st,4th,and 7th days after the operation,the C-reactive protein(CRP)in the peripheral blood of the study group was lower than that of the control group,but the difference was not statistically significant(P>0.05).The overall incidence of postoperative complications in the study group was significantly lower than those in the control group(P=0.007).The HAMA scores of the study group were lower than those of the control group on 1st day before surgery and 1st,3rd and 5th days after surgery(P<0.001).The serum prealbumin in the study group was higher than that in the control group on 4th and 7th days after operation(P<0.05).The PNI of the study group was significantly higher than that of the control group at 1 week,2 weeks and 1 month after operation(P<0.05).There was no significant difference in the incidence of adverse reactions of flupentixol and melitracen and placebo between the two groups at 1 week,2 weeks and 1 month after operation(P>0.05).Conclusions Perioperative flupentixol and melitracen is safe and effective in elderly patients with gastrointestinal cancer,which can effectively relieve anxiety/depression and promote postoperative recovery to a certain extent.
作者
高进
徐宁
王会娜
丁清竹
尤小兰
GAO Jin;XU Ning;WANG Huina;Ding Qingzu;YOU Xiaolan(Department of Gastrointestinal Surgery,Taizhou People's Hospital Affiliated to Nanjing Medical University,Tai zhou 225300,China)
出处
《中国肿瘤外科杂志》
2026年第1期78-82,87,共6页
Chinese Journal of Surgical Oncology
基金
南京医科大学泰州临床医学院科研项目(TZKY20220206)。
关键词
老年患者
胃肠道恶性肿瘤
焦虑/抑郁
心理干预
氟哌噻吨美利曲辛
Elderly patients
Gastrointestinal cancer
Anxiety/Depression
Psychological intervention
Flupentixol and melitracen
