ERAS药学服务在老年结直肠癌手术患者中的应用研究

Application of pharmaceutical service based on ERAS concept in elderly patients undergoing colorectal cancer surgery

目的 探讨加速康复外科(ERAS)理念药学服务在老年结直肠癌手术患者中的应用效果。方法 选取2023年1月~12月重庆医科大学附属永川医院就诊的122例老年结直肠癌手术患者进行研究。使用随机数字表法分为试验组(n=61)与对照组(n=61)。对照组给予常规治疗,试验组在常规治疗的基础上接受ERAS理念药学服务。干预结束后比较两组的实验室指标[白蛋白(ALB)、前白蛋白(PA)、C反应蛋白(CRP)、降钙素原(PCT)]、镇痛效果[视觉模拟评分(VAS)]、用药依从性[Morisky药物依从性量表(MMAS-8)]、住院期间并发症发生率、住院经济指标以及药品不良反应发生率。结果 术后3 d,试验组ALB、PA水平高于对照组,CRP、PCT水平低于对照组(P <0.05)。试验组VAS评分低于对照组,MMAS-8评分高于对照组(P <0.05)。试验组住院期间并发症发生率1.64%低于对照组11.48%(P <0.05)。试验组住院总费用、住院药物总费用、药占比均低于对照组(P <0.05)。试验组药品不良反应发生率3.28%低于对照组13.11%(P <0.05)结论 ERAS理念药学服务在老年结直肠癌手术患者中应用良好,可改善患者营养状态、炎症反应,减轻患者术后疼痛,提高患者用药依从性,降低住院期间并发症发生率、药品不良反应发生率,减少患者治疗费用。

Objective To explore the application of pharmaceutical service based on enhanced recovery after surgery(ERAS)elderly patients undergoing colorectal cancer surgery.Methods A total of 122 elderly patients undergoing colorectal cancer surgery in Hospital Affiliated to Chongqing Medical University were enrolled between January and December 2023.According to random number table method,they were divided into the experimental group(n=61)and the control group(n=61).The control group was given routine treatment,while experimental group was additionally given pharmaceutical service based on ERAS concept.After intervention,laboratory indexes[albumin(ALB),prealbumin(PA),C-reactive protein(CRP),procalcitonin(PCT)],analgesic effect[visual analogue scale(VAS)],medication compliance[Morisky Medication Adherence Scale(MMAS-8)],incidence of complications during hospitalization,hospitalization economy indexes and incidence of adverse drug reactions were compared between the two groups.Results At 3 days after surgery,the levels of ALB and PA in the experimental group were higher than those in the control group,while the levels of CRP and PCT were lower than those in the control group(P<0.05).VAS score in the experimental group was lower than that in the control group,and MMAS-8 score was higher than that in the control group(P<0.05).The incidence of complications during hospitalization in experimental group was lower than that in the control group(1.64%vs.11.48%,P<0.05).The total cost for hospitalization and drugs,and drug proportion in experimental group were lower than those in the control group(P<0.05).The incidence of adverse drug reactions in experimental group was lower than that in the control group(3.28%vs.13.11%,P<0.05).Conclusion Application effect of pharmaceutical service based on ERAS concept is good in elderly patients undergoing colorectal cancer surgery,which can improve nutritional status and inflammatory response,relieve postoperative pain,improve medication compliance,reduce incidence of complications during hospitalization,adverse drug reactions and treatment cost.