加速康复外科在腹腔镜结直肠癌切除术围手术期的应用效果  

Application Effect of Enhanced Recovery After Surgery in the Perioperative Period of Laparoscopic Colorectal Cancer Resection

作　　者：郭瑞 杨丽娜 郑晓艳[1] GUO Rui;YANG Lina;ZHENG Xiaoyan(Department of Gastrointestinal Surgery,Henan Provincial People’s Hospital,Zhengzhou 450000,China)

机构地区：[1]河南省人民医院胃肠外科,河南郑州450000

出　　处：《河南医学研究》2021年第32期6109-6112,共4页Henan Medical Research

摘　　要：目的探讨加速康复外科(ERAS)在腹腔镜结直肠癌切除术患者中的应用效果,并分析其对患者术后胃肠功能、炎症状态的影响。方法以随机数字表法将2019年3月至2020年12月在河南省人民医院治疗的210例结直肠癌患者分为对照组和观察组,各105例。两组患者均接受腹腔镜结直肠癌根治术,对照组患者围手术期接受常规护理,观察组患者围手术期接受ERAS护理干预。采用疼痛数字评分法(NRS)评估患者疼痛程度,采用匹兹堡睡眠质量指数(PSQI)评估患者睡眠质量,比较两组患者术后胃肠功能恢复情况、手术前后血清炎症因子水平,记录术后近期并发症情况。结果观察组患者术后肛门首次排气、排便时间,肠鸣音恢复时间均短于对照组(P<0.05)。与术前比较,术后3 d两组患者血清肿瘤坏死因子α(TNF-α)、白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CRP)水平均升高,但观察组低于对照组(P<0.05)。与术前比较,术后24 h两组患者NRS评分及术后10 d两组PSQI评分均降低,且观察组低于对照组(P<0.05)。术后住院期间观察组总并发症发生率低于对照组(P<0.05)。结论 ERAS可缓解腹腔镜结直肠癌切除术患者术后机体炎症反应状态,缓解术后疼痛程度,促进术后胃肠功能的恢复,还有助于改善患者睡眠质量,并发症少。Objective To explore the application effect of enhanced recovery after surgery(ERAS) in patients undergoing laparoscopic colorectal cancer resection,and analyze its influence on the gastrointestinal function and inflammatory state of patients after surgery.Methods Two hundred and ten patients with colorectal cancer treated in Henan Provincial People’s Hospital from March 2019 to December 2020 were divided into the control group and observation group according to the random number table method,105 cases in each group.Both groups of patients underwent laparoscopic radical resection of colon cancer,the patients in the control group received routine care during the perioperative period,and patients in the observation group were treated with ERAS nursing intervention during the perioperative period.The pain degree was assessed by numerical rating score(NRS),and The sleep quality of patients was assessed by Pittsburgh sleep quality index(PSQI).The recovery of gastrointestinal function,serum levels of inflammatory factors before and after surgery were compared between the two groups of patients,and postoperative complications were recorded.Results The time of the first postoperative gas,defecation and bowel sound recovery time of the observation group were shorter than those of the control group(P<0.05).Compared with preoperatively,the serum levels of tumor necrosis factor α(TNF-α),interleukin-6(IL-6),high sensitivity C-reactive protein(hs-CRP) increased 3 days after surgery in the two groups,but the observation group was lower than the control group(P<0.05).Compared with preoperatively,the NRS scores 24 h after surgery and the PSQI scores 10 d after surgery decreased of the two groups,and the observation group was lower than the control group(P<0.05).The total incidence of complications during hospitalization in the observation group was lower than that in the control group(P<0.05).Conclusion The ERAS can alleviate the postoperative inflammatory response in patients undergoing laparoscopic radical resection of colo

关 键 词：加速康复外科 腹腔镜结直肠癌切除术 胃肠功能 炎症 

分 类 号：R656.9[医药卫生—外科学]