Research On The Fatigue-related Factors Of Postoperative Colorectal Cancer

ObjectiveThe purpose of this study through the use of VAS,Bpoms,perioperative observation of TCM Syndrome Table of anorectal Bureau Guangdong Provincial TCM Hospital in-patients in the preoperative and postoperative clinical study of colorectal cancer after preliminary study of the characteristics of fatigue, research caused fatigue after the relevant factors,to explore traditional Chinese medicine syndromes of colorectal cancer and the relationship between postoperative fatigue,with a view to better know the clinical medicine,method of traditional Chinese and western medicine for colorectal cancer patients for the prevention and treatment of fatigue,scientific evaluation of traditional Chinese medicine treatment of the disease provide an objective basis.Methods78 case colorectal cancer surgery patients were researched in the anorectal Bureau of Guangdong Province from March 2008 to February 2009,respectively in preoperative and postoperative first day 3,7,14,30 completed vas,bpoms,Peri-operative observation of TCM Syndrome fill out forms to collect clinical data.EpiData3.1 statistical software package used to build up a database for data entry,proof-reading accuracy SPSS13.0 after the use of statistical analysis,test level=0.05.By vas,bpoms Scale preoperative and postoperative scores of the comparison,the use of descriptive analysis, calculation of measurement data after colorectal cancer characterized by fatigue.By age,gender,tumor in different phases,different surgical patients compared vas scores,and bpoms scale scores different points of the latitude to study the changes in postoperative colorectal cancer-related fatigue factor;by different TCM Syndrome Preoperative and postoperative vas scores compared to explore traditional Chinese medicine syndromes of colorectal cancer and the relationship between the characteristics of postoperative fatigue.Count data using chi-square test,measurement data for normal distribution before testing,in line with the normal distribution,the two groups were compared using a number of independent samples t test,more than a few groups were compared using analysis of variance test,inconsistent with the normal use of rank sum test.Results78 cases of patients on the vas,bpoms scale study found that 93.6 percent of preoperative patients with fatigue,after the first 3 days,7 days,100%, the first 14 days was 97.4%,the first 30 days was 92.3%,the extent of the first three days after the most serious,with the postoperative recovery gradually reduce fatigue.The degree of postoperative fatigue in patients with age,sex,tumor stage,surgical approach,factors such as traditional Chinese medicine syndromes related to the degree of fatigue with age and increased inter-group comparison P=0.004,significant difference(P＜0.01).vas scores of male patients than female patients,comparison between the two groups P =0.024,the difference was statistically significant(P＜0.05).Patients with different stages of tumor,postoperative vas scores were from low to high:Ⅰ,Ⅱ,Ⅲ,Ⅳperiod comparison between the four groups P=0.040,the difference was statistically significant(P＜0.05).Laparoscopic group and open group vas scores after the first three days in comparison P=0.021,compared seven days after the first P=0.040,the difference was statistically significant(P＜0.05),after 14 days,after 30 days,no statistical significance(P＞0.05). Prompted in the early postoperative laparoscopic group(≤days)was significantly lower than the fatigue open group,in the resumption of the late (＞7days)difference between the two groups was not significant fatigue;of open and laparoscopic group after group removal of drainage tubes,feeding, Shimoji activity compared to the results,respectively:P=0.030,P=0.042, P=0.000,the difference was statistically significance(P＜0.05),prompted after extubation in the laparoscopic group,eating,activity fields as early as the open group.bpoms by the latitude scale scores different points of comparison,suggesting that the impact of colorectal surgery in patients with psychological factors,preoperative mainly to negative mood,including fatigue,confusion,higher scores of tension,with the postoperative rehabilitation treatment,positive mood score gradually increased,negative mood to fatigue,depression,confusion-based.Patients with colorectal cancer syndromes of Chinese medicine preoperative evidence(accumulated noxious damp-heat,blood stasis temperament),and after a deficiency(blood deficiency, kidney-yin deficiency of liver,spleen kidney yang deficiency)mainly. Positive vas scores higher than after preoperative and postoperative scores decreased;Deficiency after the first three days were at the highest,with postoperative recovery,decreased scores.vas scores after pupils were as follows:qi and blood deficiency,kidney-yin deficiency of liver,spleen kidney yang deficiency,blood stasis temperament,accumulated noxious damp-heat,comparison between the five groups P=0.001,significant difference (P＜0.01).Conclusion1.Line colorectal cancer surgery patients,the existence of pre-operative fatigue 93.6%,after the first 3 days,7 days,100%,the first 14 days was 97.4%,the first 30 days was 92.3%.The first three days after the most serious degree of fatigue,with fatigue gradually reduce postoperative recovery.2.The degree of postoperative fatigue in patients with age,sex,tumor stage,surgical approach is closely related to other factors.With age,the more obvious fatigue,fatigue men than women,laparoscopic group patients with early(≤7days)was significantly lower than the fatigue open group,in the resumption of the late(＞7days)no difference between the two groups of fatigue statistical significance.3.bpoms scale through the analysis of preoperative patients with colorectal cancer the most important psychological factors are fatigue, confusion,tension and other negative mood;positive mood after scoring vitality gradually increased,negative mood to fatigue,depression, confusion-based.4.Fatigue after colorectal cancer syndromes associated with traditional Chinese medicine,different syndromes compared postoperative VAS score P=0.001,difference between the five groups significantly(P＜0.01),positive pre-operative VAS scores than patients with deficiency in patients with postoperative scores decreased;deficiency in patients with postoperative patients with scores higher than the empirical,the first three days after the highest scores,with postoperative recovery,decreased scores.