结直肠癌病人应用加速康复外科术后炎症反应和免疫功能的变化  

The impact of fast track surgery on host cell-mediated immunity and inflammatory responses for colorectal cancer patients

作　　者：王海之[1] 江志伟[1] 汪志明[1] 鲍扬[1] 柳欣欣[1] 冷强[1] 王刚[1] 谢立飞[1] 黎介寿[1] 

机构地区：[1]南京军区南京总医院普通外科,江苏南京210002

出　　处：《肠外与肠内营养》2009年第4期195-196,200,共3页Parenteral & Enteral Nutrition

基　　金：江苏省社会发展基金资助(BS2007054);南京军区科技创新基金资助(07Z028)

摘　　要：目的:该研究应用加速康复外科新理念,观察对结直肠癌病人手术后炎症反应和免疫功能的影响。方法:将30例结直肠癌手术病人随机分为两组,研究组(FTS组)病人应用加速康复外科治疗,对照组病人应用传统围手术期处理方法。观察两组病人术后首次肠道通气时间、术后住院时间和并发症,并于术前1天、术后第1天和第3天检测病人外周血清中IL-6、CRP、CD3、CD4、CD8和CD4/CD8比值。结果:FTS组与对照组比,术后住院时间显著缩短(P<0.05);术后首次排气时间显著提前(P<0.05);而术后并发症两者无显著差异。FTS组与对照组比,术后第1、3天外周血中CRP和IL-6浓度均有显著下降(P<0.05);CD4/CD8比值均有显著增加(P<0.05)。结论:应用加速康复外科能缓解结直肠癌手术病人的术后炎症反应,保护术后细胞免疫功能,促进病人快速康复。Objective ： The aim of this study was to evaluate the impact of fast track surgery on host cell-mediated immunology and inflammatory responses in colorectal cancer patients. Methods： Sixty colorectal cancer patients were prospectively divided into fast track surgery （FTS） group （ n = 30 ） and conventional perioperative care group （n = 30）. In addition to clinical parameters （recovery of gastrointestinal function, complication rates and postoperative length of stay） , the parameters of perioperative cell-mediated immunology function, and the serum level changes of CRP and IL-6 were determined. Results： FTS group was associated with a significantly shorter postoperative hospital stay compared with conventional care group（P 〈0.05）. Serum concentration of CRP and IL-6 in FTS group were lower（P 〈 0.05） than in the conventional care group on postoperative day（POD） 1 and POD 3 （P 〈0.05 ）. CD4/CD8 ratio in FTS group were higher（ P 〈 0.05 ） than in the conventional care group on postoperative day（POD） 1 and POD 3 （P 〈 0.05）. Conclusion： Fast track surgery for colorectal cancer patients can preserve cell-mediated immunity and control inflammatory responses when compared with conventional postoperative care.

关 键 词：加速康复外科 结直肠癌 细胞免疫 炎症反应 

分 类 号：R735.3[医药卫生—肿瘤]