加速康复外科减轻腹腔镜胃癌手术患者术后炎症反应  

Practice of enhanced recovery after surgery reduces postoperative inflammation in patients undergoing laparoscopic gastric cancer surgery

作　　者：王静怡 钟君[1] 杨朝纲[1] 王小姣 魏孟 陈小艳[1] 冯毕龙[1] 彭春伟[1] Wang Jingyi;Zhong Jun;Yang Chaogang;Wang Xiaojiao;Wei Meng;Chen Xiaoyan;Feng Bilong;Peng Chunwei(Department of Gastrointestinal Surgery,Zhongnan Hospital of Wuhan University,Wuhan430071,China)

机构地区：[1]武汉大学中南医院胃肠外科,武汉430071

出　　处：《中华普通外科杂志》2024年第11期833-838,共6页Chinese Journal of General Surgery

摘　　要：目的探讨加速康复外科(enhanced recovery after surgery,ERAS)在腹腔镜胃癌手术患者中的应用效果及其对患者全身炎症反应(systemic inflammatory response,SIR)的影响。方法回顾性分析2021年3月至2023年3月在武汉大学中南医院胃肠外科接受腹腔镜胃癌手术患者的临床资料。结果共纳入234例胃癌患者(ERAS组120例,常规组114例)。两组患者术前各项指标差异无统计学意义(均P>0.05)。ERAS组患者的术后通气时间、住院时间较常规组缩短,差异有统计学意义(均P<0.05)。ERAS组患者术后第1天和第3天的中性粒细胞与淋巴细胞比率、血小板与淋巴细胞比率及系统免疫炎症指数均较常规组低,差异有统计学意义(均P<0.05),术后第1天、第7天ERAS组患者的淋巴细胞与单核细胞比率较常规组高,差异有统计学意义(均P<0.05)。结论ERAS可以改善腹腔镜胃癌手术患者术后的SIR指标,通过减轻围手术期系统炎症反应,缩短患者术后恢复时间。ObjectiveTo evaluate the application of enhanced recovery after surgery in patients undergoing laparoscopic gastric cancer surgery and its impact on the systemic inflammatory response(SIR).MethodsThe clinical data of patients undergoing laparoscopic gastric cancer surgery at the Department of Gastrointestinal Surgery,Zhongnan Hospital,Wuhan University from Mar 2021 to Mar 2023 was retrospectively analyzed.ResultsA total of 234 patients with gastric cancer were enrolled(120 cases in ERAS group and 114 cases in routine group).There were no significant differences in preoperative indexes between the two groups(all P>0.05).After laparoscopic surgery,the postoperative ventilation time and hospital stay of patients in ERAS group were significantly shorter than those in the conventional group(all P<0.05).Neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR)and systemic immune-inflammatory(SII)index of patients in ERAS group were significantly lower on day 1 and day 3 after surgery than in conventional group(all P<0.05).The ratio of lymphocyte to monocyte(LMR)in ERAS group was significantly higher than that in conventional group on day 1 and day 7 after surgery(all P<0.05).ConclusionsERAS can improve postoperative SIR indexes in patients undergoing laparoscopic gastric cancer surgery,shorten postoperative recovery time,and enhance the efficacy of laparoscopic gastric cancer surgery by reducing perioperative systemic inflammation.

关 键 词：康复研究 胃肿瘤 腹腔镜手术 全身炎症反应综合征 

分 类 号：R735.2[医药卫生—肿瘤] R49[医药卫生—临床医学]