作者：李庆贤，袁锡裕，丁伟杰

单位：东莞市人民医院 胃肠外科， 广东 东莞 523000

Authors: Li Qingxian，Yuan Xiyu，Ding Weijie

Unit: Department of Gastrointestinal Surgery，Dongguan People's Hospital，Dongguan 523000，Guangdong，China

摘要：

目的 探究小剂量地塞米松联合生长抑素治疗腹腔镜结肠癌根治术后早期炎性肠梗阻的疗效及可行性。方法 选取2017年1月至2022年1月东莞市人民医院普通外科收治的腹腔镜结肠癌根治术后10 d内发生早期炎性肠梗阻患者40例，根据治疗方式的不同分为地塞米松组21例，非地塞米松组19例，地塞米松组采用小剂量地塞米松联合生长抑素治疗，而非地塞米松组采用单一生长抑素治疗，对比两组的治疗后恢复情况（肛门排便、排气恢复时间，恢复半流饮食时间，腹痛、腹胀缓解时间，腹部影像学表现改善时间），治疗后3 d、7 d、10 d的效果及治疗10 d内的缓解情况，吻合口瘘的发生等指标。结果 地塞米松组及非地塞米松组的腹痛缓解时间分别为（5.86±0.65）d和（9.32±1.16）d，腹胀缓解时间分别为（6.01±0.89）d和（9.58±1.54）d，肛门排便、排气恢复时间分别为（6.14±0.73）d和（9.16±1.30）d，生长抑素治疗时间分别为（5.90±0.89）d和（9.32±1.38）d，恢复半流饮食时间分别为（6.38±1.07）d和（9.58±1.43）d，腹部影像学表现改善时间分别为（8.81±1.17）d和（11.63±2.01）d。地塞米松组恢复速度均较非地塞米松组快（P<0.05）。治疗过程中均无吻合口瘘发生；地塞米松组和非地塞米松组总缓解率分别为95.23%和68.42%。结论 小剂量地塞米松联合生长抑素治疗腹腔镜结肠癌根治术后早期炎性肠梗阻疗效显著。

关键词：术后早期炎性肠梗阻； 地塞米松； 生长抑素； 腹腔镜结肠癌根治术

Abstract：

Objective To investigate the efficacy and feasibility of low -dose dexamethasone combined with somatostatin in the treatment of early inflammatory bowel obstruction after laparoscopic radical resection of colon cancer. Method A total of 40 patients with early inflammatory bowel obstruction within 10 days after laparoscopic radical resection of colon cancer who were admitted to the General Surgery Department of Dongguan People's Hospital from January 2017 to January 2022 were selected and divided into dexamethasone group （21 cases） and non-dexamethasone group （19 cases） according to different treatment methods. The dexamethasone group was treated with low-dose dexamethasone combined with somatostatin ，while the non -dexamethasone group was treated with single somatostatin. The recovery after treatment was compared between the two groups and the detection indicators included time to exhaust gas ，time to resume semi -fluid diet，time to improve abdominal pain and abdominal distension，time to improve abdominal imaging performance，treatment effect after 3 d，7 d，10 d and 10 d after treatment and occurrence of anastomotic leakage. Result The time of abdominal pain relief in the dexamethasone group and non-dexamethasone group were（5.86±0.65） d and（9.32±1.16） d，respectively，and the time of abdominal distension relief were （6.01±0.89） d and （9.58±1.54） d，respectively. The time of anal defecation and gas recovery were （6.14±0.73） d and （9.16±1.30） d，respectively，the time of somatostatin treatment was （5.90±0.89） d and （ 9 . 32 ± 1 . 38 ） d ， and the time to resume semi -liquid diet was respectively were （ 6 . 38 ± 1 . 07 ） d and （9.58±1.43） d，and the improvement time of abdominal imaging performance was （8.81±1.17） d and （11.63±2.01） d，respectively; the recovery speed of the dexamethasone group was higher than that of the non- dexamethasone group no anastomotic leakage occurred during the treatment process; the overall remission rates in the dexamethasone group and the non-dexamethasone group were 95.23% and 68.42%，respectively. Conclusion Low-dose dexamethasone combined with somatostatin is effective in the treatment of early inflammatory bowel obstruction after laparoscopic radical resection of colon cancer.

Key Words:  Early postoperative inflammatory bowel obstruction; Dexamethasone; Somatostatin; Laparoscopic radical resection of colon cancer