加速康复外科对肝癌患者负性情绪、术后恢复及并发症的影响

Effect of enhanced recovery surgery on negative emotion,postoperative recovery,and complication in patients with liver cancer

目的 观察加速康复外科对肝癌患者负性情绪、术后恢复及并发症的影响。方法 采用简单随机方法将108例肝癌患者分为观察组54例和对照组54例,两组患者均给予腹腔镜肝癌根治术治疗,对照组给予常规外科干预,观察组给予加速康复外科干预。比较两组患者术后康复情况、并发症发生情况,记录两组患者炎症指标[C反应蛋白(CRP)、白细胞(WBC)计数]、营养指标(白蛋白、前白蛋白)及负性情绪的变化。结果 观察组患者下床活动时间、肛门排气时间、进食半流质时间、引流管拔除时间及住院时间均明显短于对照组,差异均有统计学意义(P﹤0.01)。术后1、3、5天,两组患者CRP、WBC计数均较术前上升,白蛋白均较术前下降,但观察组患者CRP、WBC计数均低于对照组,白蛋白、前白蛋白均高于对照组,差异均有统计学意义(P﹤0.05)。干预后,两组患者抑郁自评量表(SDS)、焦虑自评量表(SAS)评分均较干预前下降,且观察组患者SDS、SAS评分均低于对照组,差异均有统计学意义(P﹤0.05)。观察组患者并发症总发生率低于对照组,差异有统计学意义(P﹤0.05)。结论 加速康复外科可缓解肝癌患者围手术期的焦虑、抑郁情绪,减轻机体应激反应,减少并发症,促进术后康复。

Objective To observe the effect of enhanced recovery surgery on negative emotion,postoperative recovery,and complication in patients with liver cancer.Method A total of 108 patients with liver cancer were randomly divided into observation group of 54 cases and control group of 54 cases by simple random method.Both groups were treated with laparoscopic radical resection of liver cancer,the control group was given routine surgical intervention,and the observation group was given enhanced recovery surgery.The postoperative recovery and complications of the two groups were compared.And the inflammatory indicators[C-reactive protein(CRP),white blood cell(WBC)counts],nutritional indicators(albumin,prealbumin),and negative emotions were recorded in the two groups of patients.Result The time of getting out of bed,anal exhaust,eating semi-liquid,removing the drainage tube,and hospital stay in the observation group were significantly shorter than those in the control group,and the differences were statistically significant(P<0.01).One,three,and five days after the operation,the CRP and WBC count in the two groups were increased compared with those before the operation,and the albumin levels were decreased compared with those before the operation,the CRP and WBC in the observation group were lower than those in the control group,and the albumin and prealbumin were higher than those in the control group,and the differences were statistically significant(P<0.05).After the intervention,the self-rating depression scale(SDS)and self-rating anxiety scale(SAS)scores of the two groups were decreased compared with those before the intervention,and the SDS and SAS scores of the observation group were lower than those of the control group,and the differences were statistically significant(P<0.05).The total incidence of complication in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclu-sion Enhanced recovery surgery could relieve perioperative anxiety and depression in patients with liver cancer,reduce the body’s stress response and complications,and promote postoperative recovery.