目的:回顾性分析胰十二指肠切除术患者术后早期应用中药的情况，明确中药对于胰十二指肠切除术后患者早期康复的疗效，为改善围手术期中西医结合治疗的疗效提供依据。方法:选取天津市南开医院2017年1月1日—2019年12月31日行开腹胰十二指肠切除术的患者共计112例。按照术后是否应用中药辅助治疗将患者分为术后应用中药组及术后未应用中药组，每组各56例。通过临床观察及查阅相关文献报道，共选取了18个术后指标，对比两组患者术后疗效指标、并发症指标及卫生经济学指标。结果:两组间术后炎症指标及肝功能指标差异无统计学意义。在胃肠功能方面，应用中药组术后恢复进食时间晚于未应用中药组[12(6，19)d vs 7(3，11)d]，差异有统计学意义(P＜0.05)。两组并发症指标无统计学差异。术后应用中药组中手术时长超过5 h、术后恢复进食时间晚、住院天数长的患者占比较多。结论:中药在胰十二指肠术后患者早期康复中起到了减少术后并发症的作用，对术后炎症指标及肝功能的恢复未见明显作用。未来仍需要高质量的前瞻性、随机对照实验来进一步探讨中药在复杂腹部手术后应用的效果。
Application of traditional Chinese medicine in the early rehabilitation after pancreaticoduodenectomy
SHEN Ping，SONG Tao，PEI Zheng-cun
Abstract:
Objective To review the application of traditional Chinese medicine in the early stage of postoperative pancreaticoduodenectomy in patients, clarify the efficacy of traditional Chinese medicine in the early rehabilitation of patients after pancreaticoduodenectomy, find the problems in the application of traditional Chinese medicine in the early postoperative rehabilitation, and provide evidence for improving the curative effect of integrated traditional Chinese and Western medicine in perioperative period. Methods A total of 112 patients underwent open pancreaticoduodenectomy in Tianjin Nankai Hospital from January 1, 2017 to December 31, 2019 were selected. Patients were divided into two groups according to whether they were treated with Chinese medicine or not. Eighteen postoperative indicators were selected to compare the postoperative efficacy, complications and health economics of the two groups. Results There were no significant differences in postoperative inflammation and liver function between the two groups. In terms of gastrointestinal function, the recovery time of postoperative feeding in the TCM group was later than that in the non-TCM group [12(6，19)d vs 7(3，11)d, P < 0.05]. There was no statistical difference in the complication indexes between the two groups. In the group of patients receiving traditional Chinese medicine after operation, the number of patients with operation duration of more than 5 hours, postoperative recovery time of food and long hospitalization days accounted for a large proportion. Conclusion In the early recovery of patients after pancreaticoduodenal surgery, Chinese medicine has played a certain role in reducing postoperative complications, but has no obvious effect on the recovery of postoperative inflammation indicators and liver function. In the future, high quality prospective, randomized controlled trials are needed to further investigate the efficacy of traditional Chinese medicine after complex abdominal surgery.
