中西医结合快速康复外科全程参与大肠癌患者围手术期的临床研究

Clinical study of Chinese Medicine in enhanced recovery after surgery participating in the perioperative period of patients with colorectal cancer

目的:观察中西医结合快速康复外科参与结肠癌患者围手术期管理后对患者康复的效果。方法:将142例大肠癌患者随机分为研究组和对照组,其中研究组患者给予中西医结合快速康复外科概念管理,对照组给予传统快速康复外科概念管理。分别比较2组患者术后疼痛、生活质量、睡眠质量、术后并发症、术后首次排气排便时间以及术后机体免疫炎症状态。结果:研究组患者术后疼痛程度明显低于对照组(P<0.05);研究组患者术后生活质量及睡眠质量要明显优于对照组(P<0.05);2组术后并发症各项的发生率比较,差异无统计学意义(P>0.05),但总发生率研究组明显低于对照组(P<0.05);研究组患者术后首次排气排便时间均较对照组有所提前(P<0.05);术后研究组患者TNF-α和IL-6均明显低于对照组(P<0.05),术后第3天,研究组CD4;T也明显高于对照组(P<0.05)。结论:将中西医结合快速康复外科概念应用于大肠癌患者的围手术期管理可提高患者的恢复能力,改善患者生活质量,值得临床推广应用。

Objective: To observe the effect of Chinese Medicine in enhanced recovery after surgery on the rehabilitation of patients with colon cancer after participating in perioperative management. Methods: One hundred and forty-two patients with colorectal cancer were randomly divided into experimental group and control group. The patients in the experimental group were given the concept management of Chinese Medicine in enhanced recovery after surgery, and the patients in the control group were given the concept management of traditional enhanced recovery after surgery. The postoperative pain, quality of life, sleep quality, postoperative complications, first postoperative exhaust and defecation time and postoperative immune inflammation were compared between the two groups. Results: The degree of postoperative pain in the experimental group was significantly lower than that in the control group(P<0.05);the quality of life and sleep in the experimental group were significantly better than those in the control group(P<0.05);there was no significant difference in the incidence of postoperative complications between the two groups(P>0.05), but the total incidence in the experimental group was significantly lower than that in the control group(P<0.05);the first time of exhaust and defecation in the experimental group was earlier than that in the control group(P<0.05);postoperative TNF-α and IL-6 in experimental group were significantly lower than those in the control group(P<0.05), and the CD4;T cell of experimental group was significantly higher than that in the control group on the 3 th day after operation(P<0.05). Conclusion: Applying the concept of Chinese Medicine in enhanced recovery after surgery to the perioperative management of patients with colorectal cancer can improve the recovery ability and quality of life of patients, which is worthy of clinical application.