加味小承气汤直肠灌肠促进食管癌术后早期胃肠功能恢复临床观察

目的 探讨加味小承气汤直肠灌肠对食管癌术后早期胃肠功能恢复的影响。方法 将60例施行食管癌手术的患者随机分为对照组（A组）、术后小承气汤空肠内营养管给药组（B组）和术后小承气汤直肠灌肠组（C组），每组20例。A组按传统方法禁食至术后首次排便，B、C组术后第1天开始每隔12 h灌肠，至首次排便后停用。观察比较术后腹胀、腹痛缓解及术后首次肛门排气、排便时间和并发症。结果 与A组比较，B组、C组术后首次肛门排气、排便时间及术后腹胀、腹痛缓解时间均明显缩短（P<0.05）；B组、C两组比较，差异无统计学意义（P>0.05），3组均无吻合口瘘、粘连性肠梗阻等严重并发症。结论 加味小承气汤直肠灌肠应用于食管癌术后早期治疗，可促进胃肠功能恢复，缩短治疗时间。

Clinical Value of Modified Xiaochengqi Decoction Rectal Enema in Promoting Early Postoperative Recovery of Gastrointestinal Function among Patients with Esophageal Cancer

Objective To investigate the effect of modified Xiaochengqi Decoction rectal enema on the early postoperative recovery of gastrointestinal function among patients with esophageal cancer. Methods Sixty surgically treated patients with esophageal cancer were randomly and equally divided into group A (control), group B, who were given Xiaochengqi Decoction through the nasojejunal feeding tube after surgery, and group C, who received a Xiaochengqi Decoction rectal enema after surgery. Group A underwent conventional fasting till the first defecation occurred after surgery, while groups B and C received an enema every 12 h from day 1 after surgery till the first defecation occurred. The two groups were compared in terms of time to postoperative abdominal distension and abdominal pain remission, time to postoperative first passage of gas by anus and defecation, and complications. Results with group A, groups B and C had significantly shortened time to postoperative abdominal distension and abdominal pain remission and time to postoperative first passage of gas by anus and defecation (P<0.05); there were no significant differences between groups B and C (P>0.05); no severe complications such as anastomotic leak and adhesive ileus were observed in the three groups. Conclusion Modified Xiaochengqi Decoction rectal enema can promote the recovery of gastrointestinal function and shorten the treatment time in patients with esophageal cancer early after surgery.