术前口服营养补充结合加速康复外科在直肠癌患者中的应用及对术后应激反应影响的疗效分析  

The Application of Preoperative Oral Nutrition Supplement Combined with Accelerated Rehabilitation Surgery in Patients with Rectal Cancer and the Curative Effect Analysis on Postoperative Stress Response

作　　者：杜永御[1] 郑伟文[1] 黄浩浩 DU Yongyu;ZHENG Weiwen;HUANG Haohao(Department of Gastrointestinal Surgery,Longyan Second Hospital,Longyan,Fujian Province,364000 China)

机构地区：[1]龙岩市第二医院肠胃外科,福建龙岩364000

出　　处：《中外医疗》2023年第6期131-134,139,共5页China & Foreign Medical Treatment

摘　　要：目的 分析术前口服营养补充结合加速康复外科(enhanced recovery after surgery,ERAS)在直肠癌患者中的应用及对术后应激反应影响的疗效。方法 随机选择2019年10月—2021年10月龙岩市第二医院行腹腔镜手术治疗的60例直肠癌患者为研究对象,以随机数表法分为两组,每组30例。对照组实施加速康复外科(ERAS)干预,研究组在对照组基础上结合术前口服营养补充。比较两组患者在入院时、术后24 h的应激反应,入院时、术后2 d免疫功能及营养指标,统计围术期情况。结果 两组术后24 h时舒张压、收缩压、疼痛评分及空腹血糖较入院时升高,研究组较对照组升高程度更低,而术后24 h时的心率、血氧饱和度较入院时降低,研究组降低程度较对照组更低,差异有统计学意义(P<0.05)。两组术后2 d免疫功能指标及营养学指标较入院时降低,研究组下降低程度较对照组更少,差异有统计学意义(P<0.05)。研究组患者术后腹痛腹胀消失时间(42.55±10.61)h、肠鸣音恢复时间(14.93±2.92)h及住院时间(12.05±1.61)d均短于对照组(53.93±12.97)h、(20.88±4.67)h、(15.72±2.01)d,差异有统计学意义(t=3.720、5.917、7.805,P<0.05)。结论 在直肠癌患者中,以ERAS结合术前口服营养补充,可减轻术后应激反应程度,改善免疫功能及营养指标,缩短术后恢复时间。Objective To analyze the application of preoperative oral nutrition supplementation combined with enhanced recovery after surgery(ERAS)in patients with rectal cancer and its effect on postoperative stress response.Methods From October 2019 to October 2021,60 patients with rectal cancer who underwent laparoscopic surgery in Longyan Second Hospital were randomly selected as the research objects.They were divided into two groups by random number table method,30 cases in each group.The control group was treated with enhanced recovery after surgery(ERAS)intervention,and the study group was treated with preoperative oral nutrition supplementation on the basis of the control group.The stress response at admission and 24 h after operation,immune function and nutritional indexes at admission and 2 d after operation were compared,and the perioperative situation was statistically analyzed between the two groups.Results The diastolic blood pressure,systolic blood pressure,pain score and fasting blood glucose at 24 h after operation in the two groups were higher than those at admission,and the increase in the study group was lower than that in the control group.The heart rate and blood oxygen saturation at 24 h after operation were lower than those at admission,and the decrease in the study group was lower than that in the control group,the difference was statistically significant(P<0.05).The immune function indexes and nutritional indexes of the two groups at 2 days after operation were lower than those at admission,and the decrease in the study group was less than that in the control group,the difference was statistically significant(P<0.05).Postoperative abdominal pain and distension disappeared time(42.55±10.61)h,bowel sound recovery time(14.93±2.92)h and hospitalization time(12.05±1.61)d in the study group were shorter than those in the control group(53.93±12.97)h,(20.88±4.67)h,(15.72±2.01)d,the difference was statistically significant(t=3.720,5.917,7.805,P<0.05).Conclusion In patients with rectal cancer,ERAS combi

关 键 词：加速康复外科 术前 营养补充 直肠癌 应用效果 应激反应 

分 类 号：R735[医药卫生—肿瘤]