快速康复外科干预对腹腔镜结直肠癌根治术患者近远期预后的影响

Effect of fast recovery surgical intervention on the short-term and long-term prognosis of patients with laparoscopic radical resection of colorectal cancer

目的探讨快速康复外科干预对结直肠癌患者近远期预后的影响。方法选取80例结直肠癌患者,均给予腹腔镜结直肠癌根治术治疗,根据围手术期干预方式的不同分为观察组和对照组,每组40例,对照组患者围手术期给予常规护理干预,观察组患者围手术期给予快速康复外科干预。比较两组患者肠壁屏障功能指标[脂多糖(LPS)、D-乳酸(D-LAC)、二胺氧化酶(DAO)]水平、疼痛程度(疼痛数字评分法)、手术相关指标、生活质量[健康调查简表(SF-36)]、并发症发生情况和预后。结果干预后,观察组患者LPS、D-LAC、DAO水平均明显低于对照组(P﹤0.01)。术后1、5天,观察组患者的疼痛程度轻于对照组(P﹤0.01)。观察组患者术中出血量明显少于对照组(P﹤0.01),首次排气时间、首次排便时间、半流质饮食时间、住院时间均明显短于对照组(P﹤0.01)。观察组患者SF-36量表各维度评分均明显高于对照组(P﹤0.01)。两组患者的并发症发生情况、局部复发情况、远处转移情况、生存情况比较,差异均无统计学意义(P﹥0.05)。结论快速康复外科干预可有效促进结直肠癌患者术后肠壁屏障功能恢复,缓解疼痛程度,提高生活质量,且远期预后较好。

Objective To investigate the effect of fast recovery surgery intervention on the short-and long-term prognosis of patients with colorectal cancer.Method A total of 80 patients with colorectal cancer were selected and given laparoscopic radical resection for colorectal cancer.The patients in the control group were given routine nursing intervention during the perioperative period,and the patients in the observation group were given the fast rehabilitation surgery intervention during the perioperative period.The intestinal barrier function indexes[lipopolysaccharide(LPS),D-lactate(DLAC),diamine oxidase(DAO)]levels,pain degree(pain digital scoring method),operation related indexes,quality of life[the MOS 36-item short form health survey(SF-36)],complications and prognosis were compared between the two groups.Result The levels of LPS,D-LAC and DAO in the observation group were significantly lower than those in the control group after intervention(P<0.01).At 1 and 5 days after operation,the degree of pain in the observation group were lower than those in the control group(P<0.01).The intraoperative blood loss in the observation group was significantly less than that in the control group(P<0.01),and the first exhaust time,first defecation time,semi liquid diet time and hospital stay significantly shorter than those in the control group(P<0.01).The scores of SF-36 in the observation group were significantly higher than those in the control group(P<0.01).There were no significant differences in the incidence of complications,local recurrence,distant metastasis and survival between the two groups(P>0.05).Conclusion Fast recovery surgery intervention can effectively promote the recovery of intestinal barrier function,relieve pain and improve the quality of life with superior long-term prognosis.