加速康复外科对高龄急腹症病人术后康复及细胞免疫功能的影响

The effect of enhanced recovery aftersurgery on postoperative rehabilitation and cellular immune function in elderly patients with acute abdomen

目的探讨加速康复外科对高龄急腹症病人的康复及对细胞免疫的影响。方法选取南阳医学高等专科学校第一附属医院2016年1月至2017年12月收治的高龄急腹症病人70例作为研究对象,分为观察组和对照组,观察组(35例)实施加速康复治疗,对照组(35例)采用传统治疗方案,对两组病人的疗效、术后并发症的发生率及对细胞免疫功能的影响进行比较。结果手术时间、术后镇痛时间、肠蠕动恢复时间、进食时间、抗生素应用时间、平均住院费用、术后住院天数、术后疼痛评分、KPS评分及术后满意度评分等指标,对照组分别为(85.1±15.8)min、(1.8±0.3)d、(27.1±5.5)h、(3.2±0.4)d、(5.1±0.5)d、(1.1±0.3)万、(8.7±0.7)d、(6.3±0.6)分、(82.6±5.3)分、(90.2±4.9);观察组分别为(70.6±13.5)min、(0.8±0.2)d、(18.9±3.2)h、(1.6±0.3)d、(3.9±0.6)d、(0.8±0.2)万、(5.9±0.8)d、(4.2±0.5)分、(90.2±6.2)分、(96.3±4.6);组间比较差异有统计学意义(P<0.05);观察组术后总并发症发生率为11.4%(4/35),对照组术后并发症的发生率为34.3%(12/35),组间比较,差异有统计学意义(P<0.05);两组病人术前及术后第4天CD3+、CD4+、CD4+/CD8+等指标组间比较,差异有统计学意义(P<0.05)。结论对高龄急腹症病人实施加速康复治疗疗效显著,并发症少,对机体的免疫功能影响小,有助于病人早期恢复。

Objective To explore the effect of enhanced recovery aftersurgery(ERAS)on postoperative rehabilitation and cellular immune function in elderly patients with acute abdomen.Methods70 cases of elderly patients with acute abdomen who were admitted to the First Affiliated Hospital of Nanyang Medical College,were selected from January 2016 to December 2017 as the research object,and were divided into observation group and control group.Observation group(35 cases)implemented enhanced recovery therapy,the control group(35 cases)used traditional treatment,the curative effect.The efficacy of the two groups of patients,incidence of postoperative complications and the impact on cellular immune function of two groups were compared.Results Operation time,postoperative analgesia,intestinal peristalsis recovery time,eating time,antibiotics application time,average hospitalization expenses,postoperative hospitalization days,postoperative pain score,KPS score and postoperative satisfaction score,etc.were compared.For the control group,they respectively were(85.1±15.8)min,(1.8±0.3)d,(27.1±5.5)h,(3.2±0.4)d,(5.1±0.5)d,(1.1±0.3)Ten thousand,(8.7±0.7)d,(6.3±0.6)points,(82.6±5.3)points,(90.2±4.9)points.The observation group:(70.6±13.5)min,(0.8±0.2)d,(18.9±3.2)h,(1.6±0.3)d,(3.9±0.6)d,(0.8±0.2)Ten thousand,(5.9±0.8)d,(4.2±0.5)points,(90.2±6.2)points,(96.3±4.6)points.The difference was statistically significant(P<0.05);The incidence of postoperative complications of observation group was 11.4%(4/35),and the control group was 34.3%(12/35).The difference was statistically significant(P<0.05).CD3+,CD4+,CD4+/CD8+were compared 4 days after surgery were compared,the difference was statistically significant(P<0.05).ConclusionEnhanced rehabilitation therapy for elderly patients with acute abdomen has obvious curative effect,few complications,and little effect on immune function,which can help patients recovery early.