胃肠外科术后ERAS及大承气冲剂对患者手术应激影响

摘要 目的：探讨胃肠外科术后加速康复外科(enhanced recovery after surgery，ERAS)及大承气冲剂对患者手术应激影响。方法：选取我院近3年所收治的80例胃肠外科手术患者，将其随机分为研究组和对照组，每组患者40例，两组患者围手术期分别采取ERAS及大承气冲剂、传统处理方法及常规西医治疗结合安慰剂，对比围手术期不同处理方式对患者手术应激影响。结果：两组患者手术前心理（汉密尔顿焦虑量表(Hamilton Anxiety Scale，HAMA)）、生理（C反应蛋白(CRP)、肾上腺素、皮质醇）应激指标对比无统计学差异（P＞0.05），手术后7 d，研究组患者各项应激指标均明显低于对照组（P＜0.05）；研究组患者术后首次排气时间、术后首次排便时间、术后首次下床活动时间、平均住院时间均明显短于对照组（P＜0.05）；两组患者手术前各营养状态对比均无统计学差异（P＞0.05），对比指标发现，各营养指标均应激降低后，逐渐恢复，研究组患者术后3 d降低程度明显低于对照组（P＜0.05），在手术后7 d逐渐恢复术前水平。结论：胃肠外科术后ERAS及大承气冲剂更有利于患者术后胃肠功能恢复，术后应激反应更轻，促使患者机体营养状态稳定，可缩短患者的住院时间，促使患者术后康复，值得临床上推广应用。

Effects of ERAS and Dachengqi Granules on Surgical Stress of Patients after Gastrointestinal Surgery

ABSTRACT Objective: To investigate the effect of ERAS and Dachengqi Granules on surgical stress in patients after gastrointestinal surgery. Methods: Eighty gastrointestinal surgery patients admitted to our hospital in the past 3 years were randomly divided into a research group and a control group, with 40 patients in each group. ERAS and Dachengqi granules were taken in the two groups, Traditional treatment methods and conventional Western medicine treatment combined with placebo, comparing the effects of different treatment methods on patients'' surgical stress during the perioperative period. Results: There was no statistically significant difference in pre-operative psychological (HAMA) and physiological (CRP, epinephrine, cortisol) stress indicators between the two groups of patients (P>0.05). Seven days after surgery, all stress indicators of the study group were obvious Lower than the control group (P<0.05). The first exhaustion time, the first postoperative defecation time, the first time after bed activity, and the average hospital stay of the study group were significantly shorter than those of the control group (P<0.05). There was no statistical difference between the nutritional status of the patients in the group before the operation(P>0.05). The comparison index found that each nutrition index gradually recovered after the stress was reduced, and the decrease in the 3 d postoperative period of the study group was significantly lower than that of the control group (P<0.05), and gradually returned to the preoperative level 7 days after the operation. Conclusion: ERAS and Dachengqi granules after gastrointestinal surgery are more conducive to the recovery of gastrointestinal function of patients after surgery, the postoperative stress response was lighter, and the nutritional status of patients is stable, which can shorten the hospitalization time of patients and encourage patients to postoperatively. Rehabilitation is worthy of clinical application.