快速康复理念对腹腔镜结直肠癌根治术预后影响分析

Effect of FTS application on prognosis in patients undergoing laparoscopic radical resection of colorectal cancer

目的探讨快速康复外科理念(FTS)在腹腔镜结直肠癌根治手术中应用对患者应激反应、血糖及疼痛水平的影响。方法回顾性分析2014年2月至2016年1月手术治疗的80例结直肠癌患者资料,根据是否采用FTS理念进行围手术期处理分为FTS组40例和常规组40例,统计软件采用SPSS 16.0进行处理,术中术后指标、白细胞介素-6(IL-6)、C反应蛋白(CRP)、皮质醇、VAS评分等采用均数±标准差进行描述,采用独立样本的t检验;并发症率发生率比较采用χ2检验;P<0.05表示差异有统计学意义。结果 FTS组患者的术后排气时间、排便时间、住院时间均显著的低于常规组(P<0.05);术前,两组患者血清IL-6、CRP、皮质醇、WBC、血糖的水平差异无统计学意义(P>0.05);术后第1、3、7 d,FTS组患者上述指标均显著的低于常规组(P<0.05);术后第1、3、5 d,FTS组患者的VAS评分均显著的低于常规组(P<0.05);FTS组患者的手术并发症率7.5%低于常规组的17.5%(P<0.05),以上差异均有统计学意义。结论 FTS在腹腔镜结直肠癌根治手术中应用有利于降低患者的应激反应、对患者的血糖影响小、减轻术后疼痛、促进患者恢复。

Objective To investigate the effect of fast track surgery （ FTS） application in patients undergoing laparoscopic radical resection of colorectal cancer on stress response , blood glucose and pain . Methods 80 cases of colorectal cancer treated in our hospital were analyzed retrospectively from 2014 Febto 2016 Jan.According to whether the FTS concept was used for perioperative management , they were divided into FTS group and conventional group , each 40 cases.Statistical analysis was performed with SPSS 16.0.The postoperative indexes , IL-6, CRP, cortisol and VAS scores were described as （ x-±s ） , compared with independent t test.The incidence of complications was compared with the χ2 test;P value〈0.05 meant that the difference was statistically significant . Results The postoperative ventilation time , defecation time and hospitalization time of the FTS group were significantly lower than those of the conventional group （ P〈0.05） . Before operation, the serum levels of IL-6, CRP, cortisol, WBC and blood glucose in the two groups were not statistically significant （P〉0.05）; The levels of IL-6, CRP, cortisol, WBC and blood glucose in the FTS group were significantly lower than those in the conventional group （ P〈0.05） on the 1st, 3rd and 5th day after operation .The VAS scores of FTS group were significantly lower than those of the conventional group on the 1st, 3rd, 5th day after operation （P〈0.05）.The complication rate of the FTS group was 7.50%which＆amp;nbsp;was lower than that of the conventional group 17.50%（P〈0.05）. Conclusion The application of FTS in laparoscopic radical resection of colorectal cancer is helpful to reduce the stress response , to decrease blood sugar fluctuation , to reduce postoperative pain and to promote the recovery of patients .