快速康复外科理念对结直肠癌根治术患者疗效及机体应激反应的影响

Application of Concept of Rapid Rehabilitation Surgery in Patients with Radical Resection of Colorectal Cancer

目的:探讨快速康复外科理念应用于结直肠癌根治术患者的疗效及其对机体应激反应的影响。方法:选取2012年1月-2013年6月我院收治的180例结直肠癌患者为研究对象,采用随机数字表法分为对照组与观察组,每组各90例。两组患者均进行结直肠癌根治术治疗,对照组患者围手术期采用传统处理措施,观察组患者围手术期采用快速康复处理措施,对比两组患者术中出血量、手术时间、术后住院时间、住院费用、术后排便时间、首次排气时间,同时比较两组患者手术当日、术后1 d、5 d血清白细胞介素-6(IL-6)、C反应蛋白(CRP)及血清淀粉样蛋白A(SAA)的水平,并观察两组患者并发症发生情况。结果:与对照组相比,观察组患者的术后住院时间、术后排便时间及首次排气时间均缩短,住院费用降低,差异有统计学意义(P<0.05),两组患者术中出血量、手术时间对比差异无统计学意义(P>0.05)。术前,两组患者的血清IL-6、CRP、SAA水平对比差异无统计学意义(P>0.05),术后1 d、5 d,两组患者血清IL-6、CRP、SAA水平均高于术前,术后5 d血清IL-6、CRP、SAA水平低于术后1 d,差异有统计学意义(P<0.05),观察组患者术后1 d、5 d血清IL-6、CRP、SAA水平均低于对照组,差异有统计学意义(P<0.05)。观察组并发症总发生率为6.67%,与对照组的7.78%比较差异无统计学意义(P>0.05)。结论:快速康复外科理念应用于结直肠癌根治术患者能够有效加快患者术后康复,降低术后应激反应,值得临床推广。

Objective： To explore the Effect of rapid rehabilitation surgery concept on the radical resection of colorectal cancer,and to analyse the stress response on the body. Methods： A total of 180 cases of colorectal cancer, who were treated in Liuzhou People＇s Hospital Affiliated to Guangxi University of Science and Technology from January 2012 to June 2013, were randomly divided into control group and observation group, 90 cases in each group. The two groups were treated with radical resection of colorectal cancer. The traditional treatment measures were adopted in the perioperative period of the control group; the measures of rapid rehabilitation surgery concept was used for the observation group during the perioperative period. The amount of bleeding, operation time, postoperative hospital stay, the cost of hospitalization, the time of postoperative defecation and the first exhaust time were compared between the two groups.At the same time, the levels of serum interleukin-6（IL-6）, C reactive protein（CRP） and serum amyloid A（SAA） in two groups of patients at operative time, 1 d and 5 d after operation were compared between the two groups. The complications in two groups were observed. Results： Compared with the control group, the time of postoperative hospital stay, the time of postoperative defecation and the first exhaust time were shortened, and the cost of hospitalization was reduced in the observation group, the differences were statistically significant（P〈0.05）. There were no significant differences in the amount of bleeding and operation time between the two groups（P〈0.05）.Before operation, there were no significant differences in serum IL-6, CRP and SAA levels between the two groups（P〈0.05）; 1 d and 5 d after operation, the levels of serum IL-6, CRP and SAA in the two groups were all higher than those before operation, the levels of IL-6,CRP and SAA 5 d after operation were lower than those 1 d after operation, the differences were statistically significant（P〈0.05）. The levels of serum IL-6, CRP and SAA in the observation group 1 d and 5 d after operation were lower than those in the control group, the difference was statistically significant（P〈0.05）. The total incidence of complications in the observation group was 6.67%, which has no significant difference compared with the total incidence of complications（7.78%） in the control group（P〈0.05）. Conclusion： The rapid rehabilitation surgery concept in the patients with radical resection of colorectal cancer can effectively accelerate the recovery of patients after operation and reduce postoperative stress response, which is worthy of clinical promotion.