磷酸肌酸钠治疗胃癌手术后疲劳综合征的效果观察

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2 g磷酸肌酸钠溶于100 mL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3 d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3 d和术后5 d治疗组均高于对照组。对照组术后5 d时的体质量、TSF、AMC均低于术前；治疗组术后5 d时的AMC低于术前，且术后5 d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。%Objective To investigate the effect of creatine phosphate sodium on postoperative fatigue syndrome (POFS) in gastric carcinoma patients. Methods Nighty cases of radical resection in gastric cancer were randomly divided into control group (n=45) and treatment group (n=45).Normal saline (100 mL) and phosphocreatine sodium (2 g) was admin-istrated intravenously after anaesthesia induction in treatment group while only normal saline was given in control group . After operation, the two groups of patients were all treated with enteral and parenteral nutrition. General performance was ob-served in both groups. Fatigue score (VAS 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) and prealbumin (PA) were examined at the same time. Results The total effective rate of the control group and the study group were 73.3%and 95.6%respectively and the difference was of statistically significant. Fa-tigue scores (VAS score) was significantly difference in both groups pre- and post-operation time points, also between 2 groups. Body mass, TSF and AMC in time points postoperation were all lower than those in the time point of preoperation. TP, ALB and PA of two groups in postoperative time points were significantly different compared with those in preoperative time point. The above indexes were all decreased with postoperation time, and these indexes in treatment group were signifi-cantly better than those in control group. Conclusion Creatine phosphate sodium can alleviate postoperative fatigue, im-prove nutritious status and promote early rehabilitation of patients.