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磷酸肌酸钠治疗胃癌手术后疲劳综合征的效果观察

许夕霞,檀碧波,魏敬妙,王敏,王玲玲,李勇   

  1. 河北医科大学第四医院
  • 收稿日期:2013-11-15 修回日期:2014-03-03 出版日期:2014-08-15 发布日期:2014-08-15
  • 通讯作者: 许夕霞

Effect of Creatine Phosphate Sodium on Postoperative Fatigue in Gastric Carcinoma Patients

  • Received:2013-11-15 Revised:2014-03-03 Published:2014-08-15 Online:2014-08-15
  • Contact: Xixia Xu

摘要:

【摘要】目的  观察磷酸肌酸钠对胃癌患者术后疲劳综合征(POFS)的影响。方法  将90例接受胃癌根治术的患者随机均分为对照组和治疗组。治疗组在手术全麻后将2g磷酸肌酸钠溶于100mL生理盐水中静脉滴注,对照组给予等容积生理盐水。术后均给予肠内、肠外营养支持治疗,观察2组症状改善情况,并监测术前和术后第1、3、5天疲劳(VAS)评分、血清总蛋白(TP)、白蛋白(ALB)、前白蛋白(PA),以及术前、术后第5天体质量、三头肌皮褶厚度(TSF)、上臂肌围(AMC)的变化。结果  对照组和治疗组总有效率分别为73.3%和95.6%。2组VAS评分均是术前最低,术后逐渐增高,至术后3d时达最高,后逐渐降低;除术前和术后1d2组差异无统计学意义外,术后3d和术后5d治疗组VAS评分均低于对照组。2组TP、ALB和PA均是术前最高,术后逐渐降低,至术后3d时达最低,后逐渐升高;2组TP、ALB除术前差异无统计学意义外,术后各时点治疗组均高于对照组;2组PA术后3d和术后5d治疗组均高于对照组。对照组术后5d时的体质量、TSF、AMC均低于术前;治疗组术后5d时的AMC低于前,且术后5d时,治疗组TSF和AMC均高于对照组,体质量与对照组差异无统计学意义。结论  磷酸肌酸钠能够有效缓解POFS,改善患者营养状况。

关键词: 胃肿瘤, 手术后并发症, 治疗结果, 磷酸肌酸钠, 术后疲劳综合征

Abstract: [Abstract] Objective   To investigate the effect of creatine phosphate on postoperative fatigue of patients with gastric carcinoma after operation.Methods   Nighty cases with gastric carcinoma were randomly divided into control group (n=45) and study group (n=45).Intravenous drip of phosphocreatine was given after anaesthesia induction in study group,and control group received normal saline instead. After operation, the two group patients were all treated with enteral and parenteral nutrition. General performance was observed in both groups. Fatigue score was measured on the day before the operation,the first,third and fifth day after operation.Body weight, triceps skinfold thickness (TSF), mid upper arm circumference (AMC), plasma total protein (TP), plasma albumin (ALB), prealbumin (PA) were detected at the same time. Results   The total effective rate of the control group and the study group were 73.3% and 95.6%, respectively, the difference was statistically significant (P<0.05). Fatigue scores was significantly higher, postoperative TSF, AMC, TP, ALB, PA of two groups were significantly decreased than preoperative, the difference was statistically significant (P<0.05); the above indexes of treatment group were significantly better than the control group, the difference was statistically significance (P<0.05). Conclusion   Creatine phosphate can alleviate postoperative fatigue, improve the nutritious status and promote early rehabilitation of patients.

Key words: stomach neoplasms, postoperative complications, treatment outcome, creatine phosphate sodium, postoperative fatigue syndrome