加速康复外科管理联合胸腺法新对腹腔镜肾癌根治术患者康复质量的影响

Effect of accelerated rehabilitation surgery management combined with thymalfasin on rehabilitation quality of patients undergoing laparoscopic radical nephrectomy

目的探讨加速康复外科管理联合胸腺法新对腹腔镜肾癌根治术患者围手术期康复质量的影响及降低手术并发症风险的作用.方法回顾性分析仁寿县人民医院2013年8月至2018年6月行腹腔镜肾癌根治术患者156例的临床资料,依据围手术期管理方案分为对照组74例、观察组82例,两组均行腹腔镜手术,观察组围手术期采用加速外科康复方案,术前、术后给予胸腺法新治疗.对照组采用传统围手术期管理方案.比较两组术中失血量、术后恢复时间及并发症发生情况.结果观察组术中丢失血红蛋白量(11.90 ± 5.61)g/L,低于对照组的(17.47 ±5.31) g/L,观察组术后引流管留置时间、肛门排气时间、住院时间分别为(35.96 ±4.47)h、(12.61 ±4.05) h、( 121.45 ±4.30) h,均明显低于对照组的(46.81 ±4.55) h、(15.34 ± 4.45)h、(193.69 ±5.48)h,均差异有统计学意义(t=6.351、15.011、4.012、92.043,均P<0.05).结论腹腔镜肾癌根治术围手术期采用加速康复外科方案联合胸腺法新是一种安全有效的治疗方式,有助于加快患者免疫功能及身体机能的恢复,缩短患者的住院时间,提高患者的康复质量.

Objective To investigate the effect of enhanced recovery after surgery program with thymalfasin in patients undergoing laparoscopic radical nephrectomy in the perioperative period to enhance the quality of rehabilitation and reduce the risk of surgical complications. Methods Retrospective analysis of the clinical data of 156 patients undergoing radical laparoscopic radical nephrectomy in the People's Hospital of Renshou County from August 2013 to June 2018 was conducted.According to the perioperative management plan, 74 patients were divided into control group(74cases) and observation group(82cases). Laparoscopic surgery was performed in both two groups.The perioperative period of the observation group was accelerated surgical rehabilitation, and thymalfasin was given before and after surgery.The control group used a traditional perioperative management program.The blood loss, postoperative recovery time and complications were compared between the two groups. Results The loss of hemoglobin during operation[(11.90±5.61)g/L]in the accelerated rehabilitation group was slightly lower than that of the control group[(17.47±5.31)g/L], and the indwelling time of plasma drainage tube, anal exhaust time and hospitalization time in the accelerated rehabilitation group were (35.96±4.47)h,(12.61±4.05)h,(121.45±4.30)h, respectively, which were significantly shorter than those in the control group[(46.81±4.55)h,(15.34±4.45)h,(193.69±5.48)h], the differences were statistically significant (t=6.351, 15.011, 4.012, 92.043, all P<0.05). Conclusion Enhanced recovery after surgery program with thymalfasin in patients undergoing laparoscopic radical nephrectomy is a safe and effective treatment.The use of thymalfasin method can accelerate the recovery of patients' immune function, and the accelerated rehabilitation program with thymalfasin can effectively reduce the probability of infection during surgery, which can effectively reduce the possibility of infection during operation, accelerate the recovery of physiological function, shorten the hospital stay of patients and improve the quality of rehabilitation of patients.