加速康复外科理念对老年食管癌微创手术病人免疫功能及并发症的影响

Influence of enhanced recovery after surgery on immune function and complications in elderly patients receiving minimally invasive surgery for esophageal carcinoma

目的研究加速康复外科(ERAS)理念对老年食管癌微创手术病人的免疫功能以及并发症的影响。方法将泰州市人民医院2015年3月至2018年2月收治的126例老年食管癌微创手术病人随机分为2组,研究组采用ERAS治疗方案,对照组采用传统治疗方案。于术后第7天检测病人的体液免疫指标和细胞免疫指标,比较2组病人术后并发症的发生率及住院天数。结果研究组的体液免疫水平(IgA、IgG、IgM)及细胞免疫水平(CD3+、CD4+、CD8+T淋巴细胞亚群)均高于对照组(P<0.05或P<0.01)。2组病人术后腹胀、腹泻、院内感染和吻合口瘘的发生率差异无统计学意义(P>0.05),研究组的住院天数较对照组短(P=0.004)。结论将ERAS理念应用于老年食管癌微创手术病人,可提升免疫力、缩短住院时间。

Objective To explore the effects of enhanced recovery after surgery(ERAS)on the immune function and complications in the elderly patients receiving minimally invasive surgery for esophageal carcinoma.Methods A total of 126 elderly patients receiving minimally invasive esophagectomy who were admitted to our hospital from March 2015 to February 2018 were enrolled in this study.They were divided into two groups,the study group receiving ERAS treatment and the control group receiving traditional treatment.On the seventh day,humoral immune function indexes and cellular immune function indexes were measured.The complications and hospitalization days of the two groups were recorded and compared.Results The levels of humoral immunity[immunoglobulin(IgA,IgG,IgM)]and cellular immunity(CD3+,CD4+,CD8+T lymphocyte subsets)in the study group were higher than those in the control group(P<0.05 or P<0.01).There was no significant difference in the incidence rate of postoperative abdominal distension,diarrhea,nosocomial infection and anastomotic leakage between the two groups.However,the length of hospital stay in the study group was shorter than that in the control group(P=0.004).Conclusions Applying the ERAS concept to the elderly patients receiving minimally invasive surgery for esophageal carcinoma can improve the immunity and shorten the hospital stay.