快速康复外科理念下肝癌肝切除患者围手术期应用新斯的明临床效果评价

Application of Perioperative Application of Neostigmine in Patients with Hepatectomy Under the Concept of Rapid Rehabilitation Surgery

目的探讨快速康复外科理念下肝切除患者围手术期应用新斯的明临床效果。方法选择2021年9月~2022年9月在福建医科大学附属协和医院接受治疗的105例肝切除患者进行研究,采用随机数表法分为研究组(n=53)和对照组(n=52)。对照组给予快速康复外科理念干预,研究组在对照组的基础上加用新斯的明治疗。比较两组首次肛门排气、首次排便时间、首次下床时间、住院时间、肌松残余消失、完全恢复时间、肝功能、炎症水平变化情况及并发症发生情况。结果术后,两组首次肛门排气、首次排便时间、首次下床时间及住院时间比较差异显著(P<0.05);术后,两组疼痛指数、离床活动时间比较差异显著(P<0.05);术前,两组肝功能指标检查无显著差异;术后,两组ALB水平均降低,但研究组高于对照组,两组ALT、AST、ALB水平均升高,但研究组低于对照组,(P<0.05);术后,两组并发症主要表现为感染、肝功能不全、胃肠道反应及胸腔积液,比较差异无统计学意义(P>0.05)。结论快速康复外科理念下应用新斯的明在肝切除中效果显著,有利于患者术后胃肠功能恢复,减轻术后肝功能损害,且不增加并发症。

OBJECTIVE To study Application of perioperative application of Neostigmine in patients with hepatectomy under the concept of rapid rehabilitation surgery.METHODS 105 patients with hepatectomy who were treated in the Union Hospital of Fujian Medical University from September 2021 to September 2022 were selected for the study.They were randomly divided into the study group(n=53)and the control group(n=52).The control group was intervened with the concept of rapid rehabilitation surgery,and the research group was treated with neostigmine on the basis of the control group.The first anal exhaust,the time of first defecation,the time of first getting out of bed,the time of hospitalization,the disappearance of residual muscle relaxation,the time of complete recovery,the changes of liver function,the level of inflammation and the occurrence of complications were compared between the two groups.RESULTS After operation,there were significant differences in the time of first anal exhaust,first defecation,first getting out of bed and length of hospital stay between the two groups(P<0.05).After surgery,there were significant differences in pain index,tracheal extubation time and movement time from bed between the two groups(P<0.05).Before operation,there was no significant difference in liver function indexes between the two groups.After surgery,ALB levels were decreased in both groups,but the study group was higher than the control group,ALT,AST and TBiL levels were increased in both groups,but the study group was lower than the control group(P<0.05).After operation,the main complications were infection,liver insufficiency,gastrointestinal reaction and pleural effusion,and there was no statistical significance between the two groups(P>0.05).CONCLUSION The application of neostigmine under the concept of rapid rehabilitation surgery has a significant effect in liver resection,which is conducive to postoperative gastrointestinal function recovery of patients,reduce postoperative liver function damage,and does not increase complications.