加速康复外科模式在行腹腔镜手术治疗结直肠癌老年患者中的应用研究
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- 论文作者：曹晓刚 ; 花红碧 ; 许世康 ; 曹能琦
- 年：2017
- 作者机构：江苏省南京市溧水区人民医院普外科;
- 论文关键词：手术应激反应 ; 结直肠癌 ; 老龄患者 ; 加速康复外科模式
- 英文论文关键词：surgical stress response ; colorectal cancer ; elderly patients ; accelerated rehabilitation surgery model
- 会议召开时间：2017-05-26
- 会议录名称：2017年《中国组织化学与细胞化学杂志》临床研讨会论文集
- 语种：中文
- 分类号：R735.34
- 学会代码：ZHXB
- 会议名称：2017年《中国组织化学与细胞化学杂志》临床研讨会
- 会议地点：中国湖北武汉
- 主办单位：《中国组织化学与细胞化学杂志》社有限公司
- 学会名称：《中国组织化学与细胞化学杂志》社有限公司
- 页数：2
- 文件大小：336k
- 原文格式：O
- 会议级别：全国
摘要
目的:探讨加速康复外科模式应用于行腹腔镜手术治疗结直肠癌老年患者的安全性、可行性和临床效果。方法:选取南京市溧水区人民医院普外科2012年03月至2016年06月接受腹腔镜手术治疗的60例老年结直肠癌患者,根据围手术期处理模式的不同分为研究组(28例)和对照组(32例),研究组围手术期给予加速康复外科模式处理,对照组围手术期给予传统模式处理。比较两组患者手术时间、术中出血量、术后C反应蛋白、催乳素、白细胞计数、IL-6和血清皮质醇水平CRP水平以及术血清营养状态的情况。结果:两组患者的IL-6水平均在术后升高,但研究组患者在术后第1天(34.4±26.1 VS 56.4±19.0)pg/ml、术后第3天(23.3±16.8 VS 30.6±21.2)pg/ml、术后第5天(15.8±25.2 VS 30.5±28.2)pg/ml的IL-6水平均明显低于对照组,均有统计学差异(P<0.05)。术后同期研究组患者的白细胞计数水平、血清皮质醇水平均低于对照组患者,但差异无统计学意义(均P>0.05);术后同期研究组患者的催乳素水平均高于对照组患者,差异无统计学意义(P>0.05)。5.研究组患者的血清前白蛋白水平在术后第5天高于对照组患者(23.1±3.4 VS 17.9±4.2)mg/dl,两组患者的转铁蛋白、前白蛋白、白蛋白、甘油三酯水平均未恢复到术前水平,且术前、术后各项指标组间比较均无统计学差异(均P>0.05)。结论:加速康复外科(ERAS)模式应用于腹腔镜手术治疗结直肠癌的老年患者安全、可行。采用加速康复外科(ERAS)模式处理的结直肠癌患者术后应激反应减轻、康复速度加快、住院时间缩短,加速康复外科(ERAS)模式优势明显,具有广泛的应用前景,值得推广。
Objective:To investigate Objective to investigate the safety,feasibility and clinical effect of ERAS in the treatment of elderly patients with colorectal cancer by laparoscopic surgery.Methods:Select the Nanjing city Lishui District Peoples Hospital Department of general surgery from 2012 03 to 2016 06 months60 cases underwent laparoscopic surgery in the treatment of elderly patients with colorectal cancer,according to perioperative management mode were divided into study group(28 cases) and control group(32 cases),the study group in perioperative period of accelerated rehabilitation surgery mode processing the control group received traditional perioperative treatment mode.The operation time,intraoperative blood loss,postoperative C reactive protein,prolactin,white blood cell count,IL-6 and serum Cortisol level of CRP,and serum nutritional status were compared between the two groups.Results:two groups of patients with elevated levels of IL-6 in postoperative all,but the team patients in postoperative day 1(34.4 + 26.1 vs.56.4 +/-19.0) pg/ml,3 days postoperatively(23.3 + 16.8 vs.30.6 +/-21.2) pg/ml and 5 postoperative days(15.8 + 25.2 vs.30.5 +/-28.2) pg/ml of IL-6 levels were significantly lower than the control group,were statistically significant(P < 0.05).Postoperative patients with the same period the team level of white blood cell count,serum Cortisol levels were lower than the control group patients,but there was no statistically significant difference(P > 0.05):Postoperative patients with the same period the team prolactin levels are higher than the control group of patients,there was no statistically significant difference(P > 0.05).5.The team in patients with serum albumin level before 5 days after surgery is higher than the control group patients(23.1+3.4 vs.17.9 +/-4.2) mg/dl,two groups of patients of transferrin,albumin,and albumin,triglyceride levels were not recovered to preoperative levels,comparison between each index and preoperative and postoperative group had no statistical difference(P > 0.05).Conclusion:accelerate rehabilitation surgery(ERAS) model is applied in laparoscopic surgery treatment of elderly patients with colorectal cancer is safe,feasible.Using accelerated rehabilitation surgery(ERAS) model stress relieve postoperative treatment of colorectal cancer patients,recovery speed,shorten the hospitalization time,accelerate rehabilitation surgery(ERAS) mode obvious advantages,has extensive application prospect and is worth promoting.
Objective:To investigate Objective to investigate the safety,feasibility and clinical effect of ERAS in the treatment of elderly patients with colorectal cancer by laparoscopic surgery.Methods:Select the Nanjing city Lishui District Peoples Hospital Department of general surgery from 2012 03 to 2016 06 months60 cases underwent laparoscopic surgery in the treatment of elderly patients with colorectal cancer,according to perioperative management mode were divided into study group(28 cases) and control group(32 cases),the study group in perioperative period of accelerated rehabilitation surgery mode processing the control group received traditional perioperative treatment mode.The operation time,intraoperative blood loss,postoperative C reactive protein,prolactin,white blood cell count,IL-6 and serum Cortisol level of CRP,and serum nutritional status were compared between the two groups.Results:two groups of patients with elevated levels of IL-6 in postoperative all,but the team patients in postoperative day 1(34.4 + 26.1 vs.56.4 +/-19.0) pg/ml,3 days postoperatively(23.3 + 16.8 vs.30.6 +/-21.2) pg/ml and 5 postoperative days(15.8 + 25.2 vs.30.5 +/-28.2) pg/ml of IL-6 levels were significantly lower than the control group,were statistically significant(P < 0.05).Postoperative patients with the same period the team level of white blood cell count,serum Cortisol levels were lower than the control group patients,but there was no statistically significant difference(P > 0.05):Postoperative patients with the same period the team prolactin levels are higher than the control group of patients,there was no statistically significant difference(P > 0.05).5.The team in patients with serum albumin level before 5 days after surgery is higher than the control group patients(23.1+3.4 vs.17.9 +/-4.2) mg/dl,two groups of patients of transferrin,albumin,and albumin,triglyceride levels were not recovered to preoperative levels,comparison between each index and preoperative and postoperative group had no statistical difference(P > 0.05).Conclusion:accelerate rehabilitation surgery(ERAS) model is applied in laparoscopic surgery treatment of elderly patients with colorectal cancer is safe,feasible.Using accelerated rehabilitation surgery(ERAS) model stress relieve postoperative treatment of colorectal cancer patients,recovery speed,shorten the hospitalization time,accelerate rehabilitation surgery(ERAS) mode obvious advantages,has extensive application prospect and is worth promoting.
引文
[1]Gustafsson UO,Oppelstrup H,Thorell A.et al.Adherence to the ERAS protocol is Associated with 5-Year Survival After Colorectal Cancer Surgery;A Retrospective Cohort Study[J],World J Surg.2016 Jul;40(7):1741-7.
[2]Chan KM,Chiang JM,Lee CF,et al.Outcomes of resection for colorectal cancer hepatic metastases stratified by evolving eras of treatment[J].World J Surg Oncol.2011 Dec 30;9:174.
[2]Chan KM,Chiang JM,Lee CF,et al.Outcomes of resection for colorectal cancer hepatic metastases stratified by evolving eras of treatment[J].World J Surg Oncol.2011 Dec 30;9:174.