快速康复外科对结直肠癌患者肠道屏障功能及术后恢复的影响研究

Effect of enhance recovery after surgery on intestinal barrier function and postoperative recovery in colorectal cancer patients

目的探讨快速康复外科对结直肠癌患者肠道屏障功能及术后恢复情况的影响,为指导临床提供参考。方法选取2018年9月至2019年1月广西医科大学第一附属医院收治的100例结直肠癌患者,按照住院号数字将患者分为观察组(快速康复外科组)和对照组(传统康复外科组),每组各50例。对照组患者接受常规手术治疗护理,观察组围手术期增加快速康复外科治疗干预。比较观察术前1d与术后3d肠黏膜屏障功能血清指标二胺氧化酶(DAO)、D-乳酸(D-LAC)及脂多糖(LPS)的变化以及两组术后恢复临床指标。结果与术前相比,术后两组DAO、D-LAC、LPS水平均升高(均P<0.05)。术前两组DAO、LPS、D-LAC水平组间比较,差异均无统计学意义(均P>0.05)。术后观察组DAO、LPS、D-LAC水平均低于对照组,差异均有统计学意义(均P<0.05)。与对照组相比,观察组术后首次肛门排气、排便时间有所提前,术后住院时间缩短,差异均有统计学意义(均P<0.05)。结论快速康复外科理念下的干预应用于结直肠癌围术期患者,有助于促进肠道功能的恢复,缩短住院时间。

Objectives To investigate the effect of enhance recovery after surgery on intestinal barrier function and postopera. tive recovery in patients with colorectal cancer. Results of the study could provide valuable information in clinical practice. Methods A total of 100 patients with colorectal cancer treated in The First Affiliated Hospital of Guangxi Medical University between September 2018 and January 2019 were recruited and assigned to treatment group and control group according to their medical record number. Patients in the control group received routine nursing care and those in the treatment group received an enhanced recovery after surgery intervention. The followings were compared between the two groups: serum levels of diamine oxi. dase (DAO), D-lactide (D-LAC) and lipopolysaccharide (LPS) one day before and three days after surgery. Results In both groups, levels of DAO, D-LAC and LPS increased significantly after surgery (P < 0.05). There was no significant difference in levels of DAO, LPS, and D-LAC before surgery between the two groups (P > 0.05). Postoperative levels of DAO, LPS, D-LAC were significantly lower in the treatment group than in the control group (P < 0.05). Compared with the control group, time to first anal exhaust, time to first defecation, and duration of hospitalization were significantly shorter in the treatment group (P < 0.05). Conclusion Enhanced recovery after surgery intervention could promote postoperative intestinal function recovery and re. duce the hospitalization time in patients with colorectal cancer.