加速康复外科用于老年胃癌手术患者的价值探讨

The value investigation of fast tract surgery on the humoral immunity and the chief clinical index of older gastric cancer patients

目的观察加速康复外科理念及方法应用于老年胃癌手术患者的有效性、安全性及其优势。方法对我院2007年5月至2009年1月期间60例老年胃癌手术患者，随机分成两组，研究组患者应用加速康复外科治疗，对照组患者应用传统围手术期处理方法。观察患者术后住院时间、住院费用、炎症反应和体液免疫指标。结果加速康复组术后平均住院天数、平均住院费用均显著低于常规对照组（P〈0．01）。两组患者术后第1天血清CRP和IL-6明显高于术前1d（P〈0．05），术后第3天较术后第1天均有所下降。但常规对照组的血清CRP和IL-6在术后比加速康复组升高的更加明显（P〈0．05）。两组患者术后第1天C3和C4水平均有所下降，但常规对照组患者的C3和C4水平在术后第1天较加速康复组降低的更加明显（P〈0．05）。结论应用加速康复外科能缓解老年胃癌手术患者术后的炎症反应，保护细胞的免疫功能，使患者术后康复加快，术后住院时间缩短，住院费用下降。

Objective To investigate the influence, salty and advantages of fast tract surgery on the humoral immunity and the chief clinical index of older gastric cancer patients. Methods Sixty patients with gastric cancer from May 2008 to January 2009 were randomly divided into two groups ： experimentgroup（ fast tract surgery group, n = 30 ） and control group （ conventional treatment group, n = 30 ）. The changes of serum levels of humoral immunity and the chief clinical index （ such as hospitalization, costs, etc. ）were analysed and compared. Results The serum levels of humoral immunity in both group were decreased. The serum levels of CRP and IL -6 on the postoperative 1 st day were significantly higher than preoperative in both groups, but the control group was more obviously higher（ P 〈 0.05 ）. The serum levels of Cs and C4 on the postoperative I st day were significantly lower than preoperative in both groups, and the control group was more obviously lower（ P 〈 0.05 ）. The duration of antibiotic use, first passage of flatus, the lengh of hospital stay, the occuranee of postoperative complications in FTS group were also significiantly lower than those in control group（ P 〈 0.05 ）. Conclusion Fast tract surgery affectes on the humoral immunity of older gasrtic cancer patients, and it might contribute to the improved outcomes of postoperative patients.