快速康复外科对胃癌根治术患者术后恢复的影响

目的探讨围手术期快速康复外科(ERAS)对胃癌患者术后恢复的影响。方法依据围手术期干预模式将95例胃癌患者分为对照组(n=33)和观察组(n=57),对照组患者围手术期接受常规护理干预,观察组患者围手术期接受ERAS模式干预。比较两组患者一般手术指标、并发症发生情况、炎性因子[肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-1β、IL-8、IL-10]水平和免疫功能指标(CD3⁺、CD4⁺、CD8⁺和CD4⁺/CD8⁺)。结果观察组患者首次下床时间、首次排气时间、首次进食时间及术后住院时间均明显短于对照组患者,差异均有统计学意义(P﹤0.01)。术后1周,两组患者TNF-α、IL-1β、IL-8、IL-10水平均明显低于本组术后2 h,且观察组患者TNF-α、IL-1β、IL-8、IL-10水平均明显低于对照组患者,差异均有统计学意义(P﹤0.01)。术后1周,两组患者CD3⁺、CD4⁺水平和CD4⁺/CD8⁺均高于本组术后2 h,观察组患者CD8⁺水平低于本组术后2 h,且观察组患者CD3⁺、CD4⁺水平和CD4⁺/CD8⁺均高于对照组患者,CD8⁺水平低于对照组患者,差异均有统计学意义(P﹤0.05)。观察组患者的术后并发症总发生率为5.26%,低于对照组患者的18.18%,差异有统计学意义(P﹤0.05)。结论ERAS模式干预可降低胃癌根治术患者围手术期的应激反应、降低炎性因子水平,增强免疫功能,从而促进患者康复。

The effect of enhanced recovery after surgery on postoperative recovery of patients undergoing radical gastric cancer surgery

Objective To investigate the effect of enhanced recovery after surgery(ERAS)on postoperative recovery of patients with gastric cancer.Method According to the perioperative intervention mode,95 patients with gastric cancer were divided into a control group(n=33,treated with conventional nursing intervention)and an observation group(n=57,treated with ERAS intervention).The general condition of operation,complications and levels of inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),interleukin-8(IL-8),interleukin-10(IL-10)]and the immune function(CD3⁺,CD4⁺,CD8⁺,and CD4⁺/CD8⁺)were compared between the two groups.Result The time of getting out of bed for the first time,the time of exhaust for the first time,the time of eating for the first time and the time of hospitalization after surgery in the observation group were shorter than those in the control group(P<0.01).One week after operation,the levels of TNF-α,IL-1β,IL-8,and IL-10 in the two groups were significantly lower than those in this group at 2 hours after operation,and the observation group’s TNF-α,IL-1β,IL-8,and IL-10 levels were significantly lower than those in the control group,and the differences were statistically significant(P<0.01).One week after operation,the levels of CD3⁺,CD4⁺and CD4⁺/CD8⁺in the two groups were higher than those in the group at 2 h after surgery,CD8⁺levels in the observation group were lower than those in the group at 2 h after surgery,and the levels of CD3⁺,CD4⁺and CD4⁺/CD8⁺in the observation group were higher than those in the control group,and the level of CD8⁺was lower than those in the control group,the differences were statistically significant(P<0.05).The total incidence of postoperative complications in the observation group was 5.26%,which was lower than 18.18%in the control group,and the difference was statistically significant(P<0.05).Conclusion ERAS mode intervention can reduce the perioperative stress response of patients undergoing radical gastric cancer surgery,reduce the level of inflammatory factors,and enhance immune function,thereby promoting the recovery of patients.