FTS在腹腔镜结直肠癌手术围术期中对老年患者应激性指标的影响探讨

Impact of FTS on stress indexes in perioperative period of laparoscopic colorectal cancer in the elderly patients

目的探讨快速康复外科(FTS)在腹腔镜结直肠癌手术围术期中对老年患者应激性指标的影响。方法128例拟行腹腔镜结直肠癌手术的老年患者作为研究对象,按照抽签分组法分为对照组和观察组,每组64例。对照组予以常规围术期干预,观察组予以FTS围术期干预。比较两组患者手术前后应激指标(皮质醇和胰岛素抵抗指数)水平以及并发症发生情况。结果术前,两组患者皮质醇水平和胰岛素抵抗指数比较差异无统计学意义(P>0.05);术后3 d,两组患者皮质醇水平和胰岛素抵抗指数均高于本组术前,且观察组患者的皮质醇水平和胰岛素抵抗指数均低于对照组,差异具有统计学意义(P<0.05)。观察组患者的并发症发生率6.25%低于对照组的18.75%,差异具有统计学意义(P<0.05)。结论FTS应用于老年患者腹腔镜结直肠癌手术围术期中可改善机体应激反应,降低术后并发症发生率。

Objective To discuss the impact of fast track surgery(FTS)on stress indexes in perioperative period of laparoscopic colorectal cancer in the elderly patients.Methods A total of 128 elderly patients with selective laparoscopic colorectal cancer as study subjects were divided into control group and observation group by lottery method,with 64 cases in each group.The control group received conventional perioperative intervention,and the observation group received FTS perioperative intervention.The stress indexes(cortisol and insulin resistance index)before and after surgery and occurrence of complications were compared between the two groups.Results Before surgery,there was no statistically significant difference in cortisol and insulin resistance index between the two groups(P>0.05).3 d after surgery,the cortisol and insulin resistance index of the two groups was higher than that before surgery of the same group,and the cortisol and insulin resistance index of the observation group was lower than that of the control group,and the difference was statistically significant(P<0.05).The incidence of complications 6.25%of the observation group was lower than that of the control group 18.75%,and the difference was statistically significant(P<0.05).Conclusion FTS in perioperative period of laparoscopic colorectal cancer can improve stress response and lower the incidence of postoperative complications.