赫兰晔 陈楠 武爱文 杨宇飞 贾小强 吴娜 李嘉俊

摘要 目的：探究結直肠癌根治性手术的患者对于中西医结合加速康复外科方案干预的依从性以及中西医结合加速康复外科方案对结直肠癌患者术后康复的影响。方法：选取2020年9月至2021年2月就诊于北京大学肿瘤医院胃肠肿瘤中心三病区接受根治性手术的结直肠癌患者216例作为研究对象，其中直肠癌120例，结肠癌96例。在围手术期应用中西医结合加速康复外科方案进行干预，记录术后排气、排便恢复的时间、围手术期并发症的情况，同时评价患者的依从性。结果：术后排气、排便的恢复时间与患者依从性的相关性具有统计学意义，依从性越好，排气、排便的恢复时间越短（P<0.05）;年龄越小，依从性越好（r=0.162，P=0.017）;有术前新辅助治疗经历的患者，依从性更好（r=-0.162，P=0.019）;依从性与受试者性别、疾病分期、并发症事件的发生没有相关性（P>0.05）。结论：结直肠癌患者术后对于中西医结合加速康复外科方案的依从性整体比较好，且患者术后肠道功能的恢复与依从性具有相关性。

关键词 中西医结合;穴位贴敷;结直肠癌;根治术;肠道功能;依从性;加速康复外科;并发症

Abstract Objective：To explore the compliance of patients undergoing radical surgery for colorectal cancer to the intervention of the fast-recovery surgical intervention of integrated traditional Chinese and western medicine， and the influence of the fast-recovered surgery combined with traditional Chinese and Western medicine on the postoperative recovery of colorectal cancer patients. Methods：A total of 216 patients with colorectal cancer who underwent radical surgery in the third ward of the Gastrointestinal Cancer Center of Peking University Cancer Hospital from September 2020 to February 2021 were selected as the research objects， including 120 cases of rectal cancer and 96 cases of colon cancer. During the perioperative period， the rapid rehabilitation surgical plan of integrated traditional Chinese and Western medicine was used to intervene， and the time of postoperative exhaust qi， defecation recovery， and perioperative complications were recorded. At the same time， the patient′s compliance information was evaluated. Results：The correlation between the postoperative recovery time of exhaust and defecation and patient compliance is statistically significant. The better the compliance， the shorter the recovery time of exhaust and defecation （P<0.05）; the younger the age， the better the compliance was （r=0.162， P=0.017）; patients with preoperative neoadjuvant treatment experience had better compliance （r=-0.162， P=0.019）; there was no correlation compliance with subjects′ gender， disease stage， and occurrence of complications （P>0.05）. Conclusion：Postoperative colorectal cancer patients have better compliance with the integrated traditional Chinese and western medicine rapid rehabilitation surgical plan， and the postoperative recovery of intestinal function is related to compliance.

Keywords Integrated traditional Chinese and western medicine; Acupoint application; Colorectal cancer; Radical operation; Intestinal function; Compliance; Enhanced recovery after surgery; Complication

中图分类号：R247.9文献标识码：Adoi：10.3969/j.issn.1673-7202.2021.09.006

结直肠癌是严重影响人类健康恶性肿瘤，国际癌症研究中心《2020年全球癌症统计数据》显示，2020年，全世界估计有181万例新的结直肠癌病例[1];在我国，2014年恶性肿瘤的流行病学显示，结直肠癌的发病率高居第3位，死亡率为第5位[2]。目前，结直肠癌的规范化诊疗指南推荐仍是基于肿瘤分期为核心的多学科综合治疗方案，如何促进术后康复、减少术后并发症，一直是临床研究的热点。

本研究团队在北京大学肿瘤医院开展了随机、双盲、安慰剂对照的临床试验，探索中西医结合加速康复外科方案在结直肠癌围手术期应用。……