快速康复外科对老年腹腔镜手术患者感染的影响

Influence of rapid rehabilitation surgery on infections in elderly patients undergoing laparoscopic surgery

目的探讨快速康复外科对老年腹腔镜手术患者感染的影响,以降低感染的发生。方法选取2011年8月-2014年8月80例结直肠癌根治手术患者为研究对象,将其随机分为观察组和对照组各40例,观察组给予腹腔镜下快速康复外科方案,对照组给予腹腔镜下结直肠癌根治术,统计两组患者术后首次排便时间、首次排气时间、住院天数及并发症,检测两组白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)水平;采用SPSS16.0软件进行统计分析。结果观察组首次排便时间、首次排气时间、住院天数短于对照组,差异有统计学意义(P<0.01);观察组术后尿路感染率、肺部感染率分别为2.5%、2.5%,低于对照组的15.0%、17.5%,差异有统计学意义(P<0.05);术后7、14d观察组血清IL-6、TNF-α水平明显低于同期对照组,差异有统计学意义(P<0.01)。结论对结直肠癌手术患者采取腹腔镜下快速康复外科方案,可缩短术后拔管时间、住院时间,减轻应激反应,且可降低感染率。

OBJECTIVE To explore the influence of rapid rehabilitation surgery on infections in the elderly patients undergoing laparoscopic surgery so as to reduce the incidence of the infections .METHODS A total of 80 patients who underwent the colorectal cancer radical surgery from Aug 2011 to Aug 2014 were recruited as the study ob‐jects and randomly divided into the observation group and the control group ,with 40 cases in each;the observation group was treated with the laparoscope‐guided rapid rehabilitation surgery program ,while the control group was given the laparoscope‐guided colorectal cancer radical surgery .The time of first postoperative defecation ,time of first exhaust ,length of hospital stay ,and complications were taken for statistics ;the levels of interleukin‐6 （IL‐6） and tumor necrosis factor‐α（TNF‐α） were detected;the statistical analysis was performed with the use of SPSS16 . 0 software .RESULTS The time of first defecation ,time of first exhaust ,and length of hospital stay of the observa‐tion group were significantly shorter than those of the control group（P〈0 .01） .The incidence of postoperative uri‐nary tract infections of the observation group was 2 .5% ,significantly lower than 15 .0% of the control group;the incidence of postoperative pulmonary infections of the observation group was 2 .5% ,significantly lower than 17 .5% of the control group（P〈0 .05） .The levels of serum IL‐6 and TNF‐αof the observation group were signifi‐cantly lower than those of the control group on day 7 and 14 after the surgeries（P〈0 .01） .CONCLUSION The lap‐aroscope‐guided rapid rehabilitation surgery program can shorten the postoperative extubation time and length of hospital stay ,alleviate the stress reactions ,and reduce the incidence of the infections in the colorectal cancer radi‐cal surgery .