快速康复外科在胰腺癌术后对血清IL-6、IL-10、TNF-α水平的影响

The influence of fast track surgery on the concentrations of serum IL-6,IL-10 and TNF-αin pancreatic cancer patients

目的探讨快速康复外科(FTS)在胰腺癌手术后对血清IL-6、IL-10及TNF-α水平的影响及其临床意义。方法入选胰腺癌手术患者80例,分为验组40例和对照组40例,检测并比较两组手术前后不同时段血浆中各指标水平。结果 (1)两组术前血清IL-6、IL-10、TNF-α水平差异无统计学意义(P>0.05);试验组术后1、3d血清IL-6水平高于术前,差异有统计学意义(P<0.05),而术后5d血清IL-6水平与术前比较,差异无统计学意义(P>0.05);对照组术后3d血清IL-6水平均高于术前(P<0.05);试验组术后同一时间段IL-6水平均低于对照组(P<0.05)。(2)试验组术后IL-10水平均高于术前(P<0.05);对照组术后1、3d血清IL-10水平高于术前(P<0.05);试验组术后同一时间段IL-10水平均高于对照组(P<0.05);(3)试验组术后1d血清TNF-α水平明显高于术前(P<0.05);术后3、5dTNF-α水平与术前差异无统计学意义(P>0.05);对照组术后1、3d血清TNF-α水平高于术前(P<0.05),而术后5d与术前差异无统计学意义(P>0.05);术后1、3d血清TNF-α,试验组明显低于对照组(P<0.05)。结论 FTS疗法能明显降低胰腺癌术后的炎性反应,改善免疫抑制,加速患者术后康复。

Objective To investigate the influence of fast track surgery（FTS） on the concentrations of serum IL-6,IL-10, and TNF-α in pancreatic cancer patients,and its clinical significance. Methods Eighty patients undergoing pancreatic cancer opera- tion were divided into FTS nursing group and traditional nursing group. The concentrations of serum IL-6, IL-10, and TNF-α in dif- ferent times before and after operation,and the same period between groups were measured. Results （1）The concentrations of ser- um IL-6, IL-10,and TNF-α were no significantly difference in two groups before operation（P〈0.05）;the concentrations of serum IL-6 in the first and third postoperative day were higher than those before operation in the observation group （P〈0.05） ;there was no significant difference of the concentrations of serum IL-6 between the fifth postoperative day and before operation（P〉0.05） ;the concentrations of serum IL-6 after operation were higher than those before operation in the control group（P〈0.05） ;the concentra- tions of serum IL-6 in the same time after operation in the observation group were lower than those in the control group（P〈0.05） （2）The concentrations of serum IL-10 in the first,third and fifth postoperative day were higher than those before operation in the observation group（P〈0.05）;the concentrations of serum IL-10 in the first and third postoperative day were higher than those be- fore operation in the control group（P〈0.05） ;the concentrations of serum IL-10 in the same time after operation in the observation group were higher than those in the control group（P〈0.05） ; （3）The concentrations of serum TNF-α in the first postoperative day were higher than those before operation in the observation group（P〈0.05） ;there was no significant difference of the concentrations of serum TNF-α between the third and fifth postoperative day and before operation（P〉0.05） ; the concentrations of serum TNF-α in the first and third postoperative day were higher than those before operation in the control group（P〈0.05） ;there was no significant difference of the concentrations of serum TNF-α between the fifth postoperative day and before operation in the control group（P〉0.05）; the concentrations of serum TNF-α in the first and third postoperative day in the observation were lower than those in the control group（P〈0.05）. Conclusion FTS could significantly reduce inflammatory reaction,improve immunosuppres- sion and helps to recover.