加速康复外科理念结合腹腔镜手术治疗结直肠癌的临床效果观察

Clinical efficacy of enhanced recovery after surgery combined with laparoscopic surgery for colorectal cancer

目的探讨加速康复外科理念结合腹腔镜手术治疗结直肠癌的临床效果。方法选取2016-01~2017-03在该院接受腹腔镜手术治疗的120例结直肠癌患者作为研究对象,采取随机数字表法将患者分为两组,每组60例。对照组患者采取常规围手术期治疗,观察组患者在加速康复外科理念指导下进行围手术期干预,比较两组患者的术后恢复情况、免疫功能指标、生活质量评分。结果观察组的肠功能恢复时间、术后住院时间均明显短于对照组(P<0.01)。两组患者术后3 d的免疫功能指标均明显降低(P<0.05),但观察组术后3 d的免疫功能指标高于对照组(P<0.05);术后7 d,观察组的免疫功能指标恢复至术前水平,而对照组的免疫功能指标仍低于术前(P<0.05)。观察组生活质量评分明显高于对照组(P<0.01)。结论接受腹腔镜手术治疗的结直肠癌患者应用加速康复外科理念进行围手术期干预,可有效提高患者的术后恢复速度,减轻手术对患者免疫功能的影响,起到保护免疫功能的作用,还可提高患者的生活质量。

Objective To explore the clinical efficacy of enhanced recovery after surgery（ ERAS） combined with laparoscopic surgery for colorectal cancer. Methods From January 2016 to March 2017,120 patients with colorectal cancer undergoing laparoscopic surgery in our hospital were selected as the study subjects. The patients were divided into two groups according to a random number table,with 60 cases in each group. The control group was performed the routine perioperative treatment,and the observation group underwent perioperative intervention guided by the concept of ERAS. The recovery results,immune function and scores of life quality were compared between the two groups. Results The recovery time of intestinal function and hospitalization time in the observation group were significantly shorter than those in the control group（ P〈0. 01）. The immune function indexes of the two groups were significantly decreased 3 days after operation（ P〈0. 05）,but the immune function indexes of the observation group was higher than those of the control group 3 days after operation（ P〈0. 05）. The immune function of the observation group returned to the preoperative level 7 days after operation,but the immune function of the control group was still lower than that before operation（ P〈0. 05）. The scores of life quality in the observation group were significantly higher than those in the control group（ P〈0. 01）. Conclusion Patients undergoing laparoscopic surgery for colorectal cancer should be treated with perioperative interventions based on the concept of ERAS,which can effectively improve the postoperative recovery rate,reduce the impact of surgery on the patients＇ immune function,protect the immune function,and improve the life quality of the patients.