快速康复外科对腹腔镜胃癌根治术患者炎症反应和免疫功能的影响

Effect of Fast-track Surgery on the Inflammatory Reaction and Immune Function of Patients with Laparoscopic Radical Gastrectomy

目的探讨快速康复外科理念对腹腔镜胃癌根治术患者术后炎症反应及免疫功能的影响。方法回顾性分析2015年5月—2016年5月该院收治的116例纳入标准的腹腔镜胃癌根治术患者资料。其中行快速康复路径的患者60例(观察组),行常规治疗56例(对照组)。比较和分析两组患者术前及术后第1、4、7天C反应蛋白(C reactive protein,CRP)、降钙素原(PCT)、CD4+/CD8+。结果两组患者CRP及PCT均较术前有所增高,对照组增高更明显(P<0.05)。术后第1天观察组CRP:(17.24±10.16)mg/L,对照组CRP:(25.31±18.20)mg/L;术后第4天观察组CRP:(13.72±4.07)mg/L,对照组:(19.82±7.78)mg/L。术后第1天观察组PCT:(1.57±1.31)ng/m L,对照组PCT:(2.27±1.19)ng/m L;术后第4天观察组PCT:(1.43±1.13)ng/m L,对照组PCT:(1.85±0.96)ng/m L。CD4+/CD8+均较术前有所下降,对照组下降更明显(P<0.05)。术后第4天观察组CD4+/CD8+:(1.20±0.22),对照组CD4+/CD8+:(1.10±0.16);术后第7天观察组CD4+/CD8+:(1.24±0.19),对照组CD4+/CD8+:(1.13±0.17)。结论快速康复外科理念有助于促进腹腔镜胃癌根治术患者术后的康复,减轻炎症反应,改善免疫功能。

Objective To study the effect of fast-track surgery on the inflammatory reaction and immune function of patients with laparoscopic radical gastrectomy.Methods 116 cases of patients with laparoscopic radical gastrectomy admitted and treated in our hospital from May 2015 to May 2016 were selected and divided into two groups,the observation group adopted the fast-track surgery with 60 cases,while the control group adopted the routine treatment with 56 cases,and the C reactive protein before operation and at 1,4 d and 7 d after operation,PCT and CD4＋/CD8＋ of the two groups were compared and analyzed.Results The CRP and PCT increased compared with those before operation in the two groups,and the increase in the control group was more obvious（P〈0.05）,and the at 1d after operation,the CRP in the observation group and in the control group was respectively（17.24±10.16）mg/L and（25.31±18.20）mg/L,the CRP at 4 d after operation was respectively（13.72±4.07）mg/L and（19.82±7.78）mg/L,and the PCT at 1 d after operation was respectively（1.57±1.31）ng/m L and（2.27±1.19）ng/m L and at 4 d after operation was respectively（1.43±1.13）ng/m L and（1.85±0.96）ng/m L,and the CD4＋/CD8＋ decreased compared with that before operation,and the decrease in the control group was more obvious（P〈0.05）,and the CD4＋/CD8＋ at 4 d after operation in the observation group and in the control group was respectively（1.20 ±0.22） and（1.10 ±0.16） and at 7 d after operation was respectively（1.24 ±0.19） and（1.13 ±0.17）.Conclusion The fast-track surgery idea contributes to promoting the recovery of patients with laparoscopic radical gastrectomy,relieve the inflammatory reaction and improve the immune function.