快速康复外科促进结直肠癌术后体液免疫功能恢复的前瞻性随机对照研究

Fast-track surgery accelerates the recovery of postoperative humoral immune function in elective operation for colorectal carcinoma： a randomized controlled clinical trial

目的本临床试验对快速康复外科对结直肠癌限期手术患者术后体液免疫功能的影响进行研究。方法70例拟接受开放限期手术的结直肠癌患者随机分为快速康复组和传统治疗组，每组35例，分别接受快速康复治疗及传统治疗，评价两组患者的临床指标及免疫指标。结果62例患者完成试验，快速康复组32例，传统治疗组30例；相对于传统治疗组，快速康复组患者术后第3天球蛋白（24．1±2．4）与（22．1±3．3）g／L（P=0．025）、免疫球蛋白G（10．79±2．39）与（8．66±2．09）g／L（P=0．007）和补体4（0．24±0．09）与（0．17±0．05）g/L（P=0．035）水平高，术后住院时间短（6．0±1．0）与（11．7±3．8）d（P〈0．001）。结论快速康复外科加速了结直肠癌限期手术患者术后部分体液免疫功能的恢复，缩短了术后住院时间。

Objective To explore the effects of fast-track surgery on postoperative humoral immune function in patients undergoing elective colorectal resection. Methods Seventy patients with colorectal carcinoma requiring colorectal resection were randomized into fast-track group （ n = 35 ） and conventional care group （ n = 35 ）. The clinical parameters and markers of humeral immune function were evaluated in both groups postoperatively. Results Sixty-two patients finally completed the study, including 32 in the fast-track group and 30 in the conventional care group. There was a significantly faster recovery of postoperative humoral immunity： blood levels of globulin （ 24. 1 ± 2.4 vs 22. 1 ± 3.3 g/L, P = 0. 025 ）, immunoglobulin G （ 10. 79 ± 2. 39 vs 8.66 ± 2. 09 g/L, P = 0. 007 ） and complement 4 （ 0. 24 ±0. 09 vs 0. 17 ±0. 05 g/L, P = 0. 035 ） at Day 3 postoperation were higher in the fast-track group than in the conventional care group. And there was also a significantly shorter length of postoperative stay （6. 0 ± 1.0 vs 11.7 ±3.8 ,d, P 〈 0. 001 ） in patients undergoing fast-track rehabilitation. Conclusion Fast-track surgery accelerates the recovery of postoperative humoral immune function in elective surgery for colorectal carcinoma with a shorter length of postoperative hospital stay.