加速康复外科对结直肠癌手术患者临床指标及免疫功能的影响

Effect of fast tract surgery on clinical index and immune function of colorectal cancer patients

关键词:  结直肠癌  加速康复外科  临床指标  免疫功能

Key words:  colorectal cancer  fast tract surgery  clinical index  immune function

摘要:

［目的］探讨在结直肠癌手术患者应用加速康复外科对临床指标及免疫功能的影响。［方法］将47例结直肠癌患者随机分为加速康复外科组（FTS组）及传统处理组。比较两组病人术后首次排气、排便时间，术后并发症发生率，住院时间及住院总费用。并比较病人术前第1天、术后第1天及第4天外周血Th1细胞因子（L-2）、Th2细胞因子（L-4）水平。［结果］FTS组首次排气、排便时间、术后并发症发生率、住院时间及住院总费用等临床指标均优于对照组，两组相比差异有显著性意义。与术前相比，FTS组L-2水平术后第1天下降明显［（32.34±9.84）pg/mL，（51.17±9.89）pg/mL，P<0.01］，术后第4天逐渐恢复，虽仍低于术前，但差异无显著性意义（P>0.05）；传统处理组术后第1、4天L-2水平明显低于术前［（27.67±11.76）pg/mL，（50.43±11.14）pg/mL，P<0.01］；［（35.78±11.74）pg/mL，（50.43±11.14）pg/mL，P<0.05］，且第4天组间比较差异有显著性意义［（47.66±9.41）pg/mL，（35.78±11.74）pg/mL ，P<0.05］。与术前相比，FTS组L-4水平术后无明升高（P>0.05）；传统处理组术后第1、4天L-4水平均明显升高［（67.98±8.12）pg/mL，（41.89±6.56）pg/mL，P<0.05］；［（65.54±7.76）pg/mL，（41.89±6.56）pg/mL，P<0.05］，且与同时段FTS组相比差异有显著性意义［（67.98±8.12）pg/mL，（47.54±7.43）pg/mL，P<0.05］；［（65.54±7.76）pg/mL，（46.33±7.30）pg/mL，P<0.05］。［结论］加速康复外科理念应用于结直肠癌手术患者可以减轻对患者免疫功能的影响，有利于患者术后的康复，减少总并发症的发生率并可节省医疗费用。

Abstract:

［Objective］To investigate the influence of fast tract surgery on clinical index and immune function of colorectal cancer patients.［Methods］Forty-seven patients with colorectal cancer were divided into two groups:fast tract surgery (FTS) group (n=23) and control group (n=24). The time of first flatus and defecation, complications, the hospitalized period and the cost during hospitalization were compared. Interlcukin-2 (L-2) and interlcukin-4 (L-4) on 1 day before and first and fourth day after operation were measured.［Results］The first time of flatus and defecation, the occurrence of post-operation complications, the hospitalized period and the cost during hospitalization in FTS group were significantly higher than those in control group (P<0.05). The level of L-2 was decreased significantly on post-surgery day in FTS group ［(32.34±9.84)pg/mL, (51.17±9.89)pg/mL, P<0.01］, but it was gradually increased to the level of pre-operation on 4th day after operation (P>0.05) and it was still significantly lower in control group than that in FTS group ［(47.66±9.41)pg/mL, (35.78±11.74)pg/mL, P<0.05］. The level of L-4 post-operation was not increased significantly in FTS group, whereas it was increased significantly in control group ［(67.98±8.12)pg/mL, (41.89±6.56)pg/mL, P<0.05］;［(65.54±7.76)pg/mL, (41.89±6.56)pg/mL, P<0.05］, and there was significant difference between two groups ［(67.98±8.12)pg/mL, (47.54±7.43)pg/mL, P<0.05］;［(65.54±7.76)pg/mL, (46.33±7.30)pg/mL, P<0.05］.［Conclusion］Fast tract surgery affects less on immune function, and it might contribute to recovery, re-duce the rate of overall complications and save the medical resources in patients with colorectal cancer.