腹腔镜全子宫切除术联合FTS-CNP模式对患者营养及PCT、IL-6、CRP的影响

Effects of total laparoscopic hysterectomy combined with fts-cnp model on nutrition,PCT,IL-6 and CRP of patients

目的研究腹腔镜全子宫切除术联合加速康复外科临床治疗路径(FTS-CNP)模式对患者营养及降钙原素(PCT)、白介素6(IL-6)、C反应蛋白(CRP)的影响。方法选取2017年10月至2019年10月太仓市第一人民医院妇科收治的76例需行子宫切除术的患者,按照住院号单双数将其分为对照组和研究组,各38例。对照组进行传统开腹手术,研究组进行腹腔镜全子宫切除术。2组均实施FTS-CNP模式进行手术护理,持续至术后5 d。以患者术前、术后1、3、5 d PCT、IL-6、CRP、全血白细胞计数(WBC)以及营养指标(白蛋白、前白蛋白)作为观察指标,并记录患者术后并发症发生率。结果研究组手术时间、术后排气时间、下地活动时间均显著短于对照组,手术出血量均显著低于对照组(P<0.05);与术前比,术后1~5 d 2组血清IL-6、CRP、WBC、PCT水平呈先升高后降低趋势,且研究组始终显著低于对照组(P<0.05);与术前比,术后1~5 d 2组血清白蛋白、前白蛋白水平呈先降低后升高趋势,且研究组始终显著高于对照组(P<0.05);研究组术后并发症发生率(2.63%)显著低于对照组(15.78%)(P<0.05)。结论腹腔镜全子宫切除术联合FTS-CNP模式可减轻子宫疾病患者炎症反应,维持良好的营养状态,促进术后康复,并降低并发症发生率。

Objective To study the effects of total laparoscopic hysterectomy combined with fts-cnp on nutrition,PCT,IL-6 and CRP in patients.Methods A total of 76 patients requiring hysterectomy admitted to the department of gynecology of taicang first people's hospital from October 2017 to October 2019 were selected and divided into the control group and the research group,with 38 patients in each group,according to the number of patients admitted in the hospital.The control group underwent traditional open surgery and the research group underwent laparoscopic total hysterectomy.Both groups received surgical nursing in fts-cnp mode,which lasted until 5 days after the operation.PCT,IL-6,CRP,WBC and nutritional indicators(albumin and prealbumin)were used as the observation indicators before and after operation,1,3 and 5 days,and the incidence of postoperative complications was recorded.Results The operation time,postoperative exhaust time and time of going to the ground in the study group were significantly shorter than those in the control group,and the amount of surgical bleeding was significantly lower than those in the control group(P<0.05).Compared with the preoperative study,serum levels of IL-6,CRP,WBC and PCT in the two groups first increased and then decreased on day 1~5 after surgery,and the study group was always significantly lower than the control group(P<0.05).Compared with the preoperative level,the serum albumin and pre-albumin levels of the two groups first decreased and then increased on day 1~5 after the surgery,and the study group was always significantly higher than the control group(P<0.05).The incidence of postoperative complications in the study group(2.63%)was significantly lower than that in the control group(15.78%)(P<0.05).Conclusion Laparoscopic total hysterectomy combined with fts-cnp model can reduce the inflammatory response of patients with uterine diseases,maintain good nutritional status,promote postoperative rehabilitation,and reduce the incidence of complications.