围术期加速康复外科干预对腹腔镜结直肠癌根治术患者应激指标和营养指标的影响  

Effect of perioperative enhanced recovery after surgery intervention on the stress index and nutritional index of patients undergoing laparoscopic radical resection for colorectal cancer

作　　者：于浩[1] 李光云[1] 许建国[1] 谢坤领 Yu Hao;Li Guangyun;Xu Jianguo;Xie Kunling(Department of Gastrointestinal Surgery,Bozhou People's Hospital,Anhui,Bozhou 236800,China)

机构地区：[1]亳州市人民医院胃肠外科,安徽亳州236800

出　　处：《中国医学前沿杂志（电子版）》2020年第7期88-92,共5页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

基　　金：安徽理工大学青年科学研究基金(QN2018126)。

摘　　要：目的探讨围术期加速康复外科(enhanced recovery after surgery,ERAS)干预对腹腔镜结直肠癌根治术患者应激指标和营养指标的影响。方法选取2018年3月至2019年3月亳州市人民医院收治的行腹腔镜结直肠癌根治术患者88例为研究对象,根据随机数字表法将患者分为对照组(44例)和观察组(44例),对照组患者在围术期采用常规干预,观察组患者围术期采用ERAS干预;比较两组患者术后应激指标、营养指标、排便时间、进食时间、住院天数和并发症发生情况。结果术后1 d、5 d,两组患者肾上腺素(epinephrine,E)、去甲肾上腺素(norepinephrine,NE)、白介素-6(interleukin-6,IL-6)、C反应蛋白(C reactive protein,CRP)水平均显著高于本组术前(均P<0.05);术后5 d,两组患者E、NE、IL-6、CRP水平均显著低于本组术后1 d(均P<0.05);术后1 d、5 d,观察组患者E、NE、IL-6、CRP水平均显著低于同时点对照组(均P<0.05)。术后5 d,两组患者整体营养状况主观评估量表(patient-generated subjective global assessment,PG-SGA)评分均显著高于本组术前(均P<0.05),血清白蛋白(albumin,Alb)、前白蛋白(prealbumin,PA)、血红蛋白(hemoglobin,Hb)水平均显著低于本组术前(均P<0.05);术后5 d,观察组患者PG-SGA评分显著低于对照组(P<0.05),血清Alb、PA、Hb水平均显著高于对照组(均P<0.05)。观察组患者排便时间、进食时间、住院天数均显著短于对照组(均P<0.05),观察组患者术后并发症总发生率显著低于对照组(P<0.05)。结论腹腔镜结直肠癌根治术患者围术期给予ERAS干预,可显著减轻应激反应,改善营养状况,缩短住院天数,减少并发症发生。Objective To explore the effect of perioperative enhanced recovery after surgery(ERAS)intervention on the stress index and nutrition index of patients undergoing laparoscopic radical resection for colorectal cancer.Method A total of 88 patients undergoing laparoscopic radical resection for colorectal cancer in Bozhou People's Hospital from March 2018 to March 2019 were selected as research objects.According to the random number table method,patients were divided into control group(44 cases)and observation group(44 cases).Control group patients received routine intervention during perioperative period,and observation group patients received ERAS intervention.Postoperative stress index,nutrition index,defecation time,feeding time,hospital day and complications were compared between the two groups.Result 1 day and 5 days after surgery,the levels of epinephrine(E),norepinephrine(NE),interleukin-6(IL-6)and C reactive protein(CRP)in the two groups were significantly higher than those before surgery(all P<0.05);5 days after surgery,E,NE,IL-6 and CRP levels in the two groups were significantly lower than those 1 day after surgery(all P<0.05);1 day and 5 days after surgery,E,NE,IL-6 and CRP levels in observation group were significantly lower than those in control group(all P<0.05).5 days after surgery,the scores of patient-generated subjective global assessment(PG-SGA)in the two groups were significantly higher than those before surgery(all P<0.05),and serum albumin(Alb),prealbumin(PA)and hemoglobin(Hb)levels were significantly lower than those before surgery(all P<0.05);5 days after surgery,the PG-SGA score in observation group was significantly lower than that in control group(P<0.05),and serum Alb,PA and Hb levels were significantly higher than those in control group(all P<0.05).The defecation time,feeding time and hospital day in observation group were shorter than those in control group(all P<0.05),and the incidence of postoperative complications in observation group was significantly lower than that in control grou

关 键 词：加速康复外科 腹腔镜结直肠癌根治术 应激 营养状况 

分 类 号：R735.34[医药卫生—肿瘤]