加速康复外科对喉癌手术患者术后快速恢复、应激反应和并发症的影响

Effect of enhanced recovery after surgery concept on postoperative rapid recovery, stress response, and complications in patients with laryngeal cancer surgery

目的:探究加速康复外科(enhanced recover y af ter surger y,ERAS)对喉癌手术患者术后快速恢复、应激反应和并发症的影响。方法:选取2019年1月到2021年3月南京医科大学第一附属医院收治的120例喉癌患者为研究对象,按随机数字表法将患者随机分为对照组与观察组,每组60例。对照组予以常规护理干预,观察组予以ERAS护理干预。比较两组术后恢复、应激反应[白细胞介素-6(interleukin-6,IL-6)、C反应蛋白(C-reactive protein,CRP)]、营养状况[血红蛋白(hemoglobin,Hb)、血清白蛋白(ser um albumin,ALB)]及并发症情况。结果:观察组术后鼻胃管佩戴时间、气管套管佩戴时间、术后住院天数均明显短于对照组(均P<0.05)。观察组术后1、3、5 d时血清IL-6、CRP水平均明显低于对照组(均P<0.05)。观察组术后5 d时Hb、ALB水平均明显高于对照组(均P<0.05)。观察组并发症总发生率明显低于对照组(5.00%vs 16.67%,P<0.05)。结论:ERAS可有效促进喉癌手术患者术后快速恢复,减轻其应激反应,降低并发症发生率。

Objective:To explore the effect of enhanced recovery after surgery(ERAS)on postoperative rapid recovery,stress response,and complications of patients with laryngeal cancer.Methods:A total of 120 patients with laryngeal cancer admitted to First Affiliated Hospital of Nanjing Medical University from January 2019 to March 2021 were selected as the study subjects.The patients were randomly divided into a control group and an observation group according to the random number table method,with 60 cases in each group.The control group was given routine nursing intervention,and the observation group was given ERAS nursing intervention.The postoperative recovery, stress response [interleukin-6 (IL-6), C-reactive protein (CRP)], nutritional status [hemoglobin (Hb), serum albumin (ALB)] and complications were compared between the 2 groups. Results: The postoperative nasogastric tube wearing time, tracheal tube wearing time, and postoperative hospital stay in the observation group were significantly shorter than those in the control group (all P<0.05). The levels of serum IL-6 and CRP in the observation group were significantly lower than those in the control group at 1, 3 and 5 d after the operation (all P<0.05). The levels of Hb and ALB in the observation group at 5 d after operation were significantly higher than those in the control group (both P<0.05). The total incidence of complications in the observation group was significantly lower than that in the control group (5.00 % vs 16.67 %, P<0.05). Conclusion: ERAS can effectively promote the rapid postoperative recovery of patients with laryngeal cancer surgery, reduce their stress response, and reduce the incidence of complications.