加速康复外科理念对结肠癌手术患者临床症状及免疫功能的影响
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四川省卫生和计划生育委员会科研课题(16PJ574)


Effect of fast track surgery on clinical symptoms and immune function in patients with colon cancer surgery
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    摘要:

    目的 探讨加速康复外科理念对结肠癌手术患者临床症状及免疫功能的影响。方法 回顾性分析自贡市第四人民医院普外一科及南充市中心医院普外科接受手术治疗的38例结肠癌患者的临床资料,依据围手术期处理方法的不同分为对照组18例及观察组20例,对照组患者接受常规处理方法,观察组患者接受加速康复处理方法,比较两组患者手术前后临床表现相关指标、炎症指标、免疫球蛋白水平和细胞免疫功能。结果 观察组患者口渴、饥饿发生率及住院时间、首次排气时间、首次排便时间、首次接受半流质时间均优于对照组,差异有统计学意义(P<0.05);两组患者手术时间比较差异无统计学意义(P>0.05)。观察组患者CRP、IL-6表达水平低于对照组,差异有统计学意义(P<0.05)。两组患者T0时点IgA、IgM、IgG水平比较,差异无统计学意义(P>0.05);观察组患者T1、T2时点IgA、IgM、IgG水平显著低于对照组,差异有统计学意义(P<0.05)。两组患者T0时点CD3、CD4、CD8、CD4/CD8比较,差异无统计学意义(P>0.05);观察组患者T1、T2时点CD3、CD4、CD8、CD4/CD8水平优于对照组,差异有统计学意义(P<0.05)。结论 加速康复外科理念可显著优化结肠癌患者术后临床指标,提高机体细胞免疫功能,可推荐应用。

    Abstract:

    Objective To investigate effect of fast track surgery on clinical symptoms and immune function in patients with colon cancer surgery. Methods The clinical data of colorectal cancer patients in general surgery department of Sichuan Zigong Fourth People's Hospital and department of general surgery of Nanchong Central Hospital were retrospectively analyzed. According to the different surgical treatment, the patients were divided into control group and observation group. The patients in the control group received routine treatment, and the patients in the observation group received the fast track treatment. The clinical symptoms, inflammation index, immunoglobulin level and cellular immune function were compared between the two groups before and after surgery. Results The incidence of thirst, hunger and hospitalization time, the first exhaust time, the first defecation time and the first time to accept semi liquid time in the observation group were better than those in the control group, the difference was statistically significant (P<0.05). The operation time of the two groups was not statistically significant (P>0.05). The CRP and IL6 in the observation group were lower than those in the control group, and the difference was statistically significant (P<0.05). There was no significant difference in IgA, IgM and IgG between the two groups at T0 P>0.05). At T1 and T2, the level of IgA, IgM and IgG in the observation group was significantly lower than that of the control group, and the difference was statistically significant (P<0.05). The levels of CD3, CD4, CD8 and CD4 / CD8 at T0 were not significantly different between the two groups (P>0.05). The levels of CD3, CD4, CD8 and CD4 / CD8 at T1 and T2 in the observation group were better than those in the control group Significance (P<0.05). Conclusion The value of fast track surgery can significantly optimize the postoperative clinical symptoms and improve the cellular immune function of patients with colon cancer, and worth recommending for application.

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  • 在线发布日期: 2018-07-17
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