快速康复外科技术对结直肠癌患者免疫功能的影响及应用效果

目的探讨快速康复外科技术在结直肠癌患者围手术期对机体免疫功能的影响及应用效果。方法将入选的60例拟接受手术治疗的结直肠癌患者随机分为快速康复组（A组）和传统治疗组（B组），每组30例。比较两组患者术前和术后第1、3、7天血清免疫球蛋白IgA、IgM、IgG和C反应蛋白（CRP）水平，并对两组患者住院时间、治疗费用、首次排气时间、并发症等进行比较。结果A组和B组术后第3天血清IgA、IgG和IgM分别为（1．55±0．35）g/L与（1．22±0．40）g／L，P〈0．05；（9．88±1．98）g／L与（9．01±2．35）g／L，P〈0．05；（0．89±0．22）g／L与（0．81±0．30）g/L，P〈0．05]；A组和B组术后第1、3、7天的血清CRP水平分别为（51±12）g／L与（83±10）g／L，P〈0．05；（136±16）g／L与（169±17）g／L，P〈0．05；（57±10）g／L与（80±9）g／L，P〈0．05]。A组和B组术后首次排气时间（3．2±0．7）d与（4．8±0．6）d，P〈0．05]、住院时间（7．6±1．1）d与（9．0±0．8）d，P〈0．05]以及住院费用（13250±1800）元与（16356±2315）元，P〈0．05]；A组术后并发症发生率较B组低（P〈0．05）。结论快速康复外科的应用能够减轻对患者机体的免疫损伤，有效促进术后胃肠道功能的恢复，降低并发症发生率，缩短住院时间，节省住院费用。

Effect if fast track surgery on patients with colorectal carcinoma

Objective To investigate the effect of fast track surgery on immunologic functions and clinical application in patients with colorectal carcinoma during perioperative period.Methods 60 colorectal carcinoma pa-tiens receving radical operation were randomly divided into two groups:fast track surgery group(group A,30 cases)and conventional mmmgement group(group B,30cases).Serum levels of IgA、IgM、IgG and C reaction protein(CRP) in 60 patients were assayed preoperatively and postoperatively on 1st,3rd,7th day.The postoperative hospital stay,to-tal cost during hospitalization,the time of the first flatus,overall complications were compared.Results On the post-operative 3rd day,serum levels of IgA(1.55±0.35)g/L vs(1.22±0.40)g/L,P<0.05],IgG(9.88 ±1.98)g/L vs(9.01±2.35)/L,P<0.05]and IgM(0.89±0.22)g/L vs(0.81±0.30)g/L,P<0.05]in group A were significandy higher than in group B.On the postoperative 1st,3rd,7th day,serum level of CRP d1(51±12)g/L vs (83 ±10)g/L,P<0.05],d3(136 ±16)g/L vs(169±17)g/L,P<0.05],d7(57±10)g/L vs(80±9)g/L,P<0.05]in group A were significantly lower than in group B.The time of the first flatus(3.2±0.7)d vs(4.8±0.6)d,P<0.05],time of hospitalday(7.6±1.1)d vs(9.0±0.8)d,P<0.05]and the total cost during hospitalization (1 3250 ±l 800)￥vs(1 6356±2 315)￥,P<0.05]were also significantly lower than in group B(P<0.05).Compared with group B,there were less rate of overall complications in group A(P<0.05).Conclusion Fast track surgery mitigates the immunologic impairment of colorectal cancer patients during perioperative period,and accelerate recovery of gastrointestinal function,reduce the rate of complications and total cost during hospitalization,shorten post-operative hospital stay.