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加速康复外科对结直肠癌手术患者临床指标及免疫功能的影响 被引量:4

Effect of fast tract surgery on clinical index and immune function of colorectal cancer patients
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摘要 [目的]探讨在结直肠癌手术患者应用加速康复外科对临床指标及免疫功能的影响。[方法]将47例结直肠癌患者随机分为加速康复外科组(FTS组)及传统处理组。比较两组病人术后首次排气、排便时间,术后并发症发生率,住院时间及住院总费用。并比较病人术前第1天、术后第1天及第4天外周血Th1细胞因子(L-2)、Th2细胞因子(L-4)水平。[结果]FTS组首次排气、排便时间、术后并发症发生率、住院时间及住院总费用等临床指标均优于对照组,两组相比差异有显著性意义。与术前相比,FTS组L-2水平术后第1天下降明显[(32.34±9.84)pg/mL,(51.17±9.89)pg/mL,P<0.01],术后第4天逐渐恢复,虽仍低于术前,但差异无显著性意义(P>0.05);传统处理组术后第1、4天L-2水平明显低于术前[(27.67±11.76)pg/mL,(50.43±11.14)pg/mL,P<0.01];[35.78±11.74)pg/mL,(50.43±11.14)pg/mL,P<0.05],且第4天组间比较差异有显著性意义[(47.66±9.41)pg/mL,(35.78±11.74)pg/mL,P<0.05]。与术前相比,FTS组L-4水平术后无明升高(P>0.05);传统处理组术后第1、4天L-4水平均明显升高[(67.98±8.12)pg/mL,(41.89±6.56)pg/mL,P<0.05];[(65.54±7.76)pg/mL,(41.89±6.56)pg/mL,P<0.05],且与同时段FTS组相比差异有显著性意义[(67.98±8.12)pg/mL,(47.54±7.43)pg/mL,P<0.05];[(65.54±7.76)pg/mL,[(46.33±7.30)pg/mL,P<0.05]。[结论]加速康复外科理念应用于结直肠癌手术患者可以减轻对患者免疫功能的影响,有利于患者术后的康复,减少总并发症的发生率并可节省医疗费用。 [Objective] To investigate the influence of fast tract surgery on clinical index and immune function of colorectal cancer patients.[Methods] Forty-seven patients with colorectal cancer were divided into two groups:fast tract surgery(FTS) group(n=23)and control group(n=24).The time of first flatus and defecation,complications,the hospitalized period and the cost during hospitalization were compared.Interlcukin-2(L-2) and interlcukin-4(L-4) on 1 day before and first and fourth day after operation were measured.[Results] The first time of flatus and defecation,the occurrence of post-operation complications,the hospitalized period and the cost during hospitalization in FTS group were significantly higher than those in control group(P0.05).The level of L-2 was decreased significantly on post-surgery day in FTS group [(32.34±9.84)pg/mL,(51.17±9.89)pg/mL,P0.01],but it was gradually increased to the level of pre-operation on 4th day after operation(P0.05) and it was still significantly lower in control group than that in FTS group [(47.66±9.41)pg/mL,(35.78±11.74)pg/mL,P0.05].The level of L-4 post-operation was not increased significantly in FTS group,whereas it was increased significantly in control group [(67.98±8.12)pg/mL,(41.89±6.56)pg/mL,P0.05];[(65.54±7.76)pg/mL,(41.89±6.56)pg/mL,P0.05],and there was significant difference between two groups [(67.98±8.12)pg/mL,(47.54±7.43)pg/mL,P0.05];[(65.54±7.76)pg/mL,(46.33±7.30)pg/mL,P0.05].[Conclusion] Fast tract surgery affects less on immune function,and it might contribute to recovery,reduce the rate of overall complications and save the medical resources in patients with colorectal cancer.
作者 孙哲 张毅
出处 《大连医科大学学报》 CAS 2010年第3期290-293,共4页 Journal of Dalian Medical University
关键词 结直肠癌 加速康复外科 临床指标 免疫功能 colorectal cancer fast tract surgery clinical index immune function
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参考文献10

  • 1Wilmore DW,Kehlet H.Management of patients in fast track surgery[J].BMJ,2001,322(24):473-476.
  • 2Wilmore DW.From Cath bertson to fast track surgery:70 years of progression in reducing stress in surgical patients[J].Ann Surg,2002,236(5):643-648.
  • 3Kehlet H,Büchler MW,Beart RWJ,et al.Care after colonic operation is it evidence based? Results from amultinational survey in Europe and the United states[J].J Am Coll Surg,2006,202 (1):452-454.
  • 4江志伟,李宁,黎介寿.快速康复外科的概念及临床意义[J].中国实用外科杂志,2007,27(2):131-133. 被引量:1385
  • 5Fearon KC,Ljungqvist O,Von MeyenfeldtM,et al.Enhanced recovery after surgery:a consensus review of clinical care for patients undergoing colonic resection[J].Clin Nutr,2005,24 (3):466-477.
  • 6Bucher P,Gervaz P,Soravia C,et al.Randomized clinical trial of mechanical bowel reparation versus no preparation before elective left sided colorectal surgery[J].Br J Surg,2005,92 (4):409-411.
  • 7Correia MI,da Silva RG.The impact of early nutrition on metabolic response and postoperative ileus[J].Curr Opin Clin Nutr Metab Care,2004,7 (5):577-583.
  • 8Kaboli P,Henderson MC,White RH.DVT prophylaxis and anticoagulation in the surgical patients[J].Med Clin North Am,2003,87 (1):77-110.
  • 9姚金晶,陈宜涛.Th1/Th2平衡调节与疾病发生的研究进展[J].现代生物医学进展,2009,9(13):2597-2600. 被引量:119
  • 10奚庆华,叶青,徐云钊,张玉泉.腹腔镜卵巢良性肿瘤切除手术对患者免疫功能的影响[J].中国肿瘤,2009,18(6):503-505. 被引量:9

二级参考文献40

  • 1张旸,曹颖平,杨升,陈卫闽.原发性肝癌患者手术前后Th1类细胞因子的水平变化[J].宁夏医学杂志,2007,29(7):581-583. 被引量:6
  • 2Buunen M,Gholghesaei M,Veldkamp R,et al.Stress response to laparoscopic surgery:a review[J].Surg Endosc,2004,18(7):1022-1028.
  • 3Romagnani S.Lymphokine production by human T cells in disease states[J].Annu Res Immunol,1994,12:227-257.
  • 4Decker D,Schondorf M,Bidling maier P,et al.Surgieal stress induces a shift in the type 1/type2 T-helper cell balance,suggesting down-regulation of cell-mediated and up-regulation of antibody-mediated immunity commensurate to the trauma[J].Surgery,1996,119(5):316-325.
  • 5Lassmann H.Hypoxia-like tissue injury as a component of multiple sclerosis lesions[J].Neurol Sci,2005,206(6):187-191.
  • 6Carreno BM,Collina M.The B7 family of ligands and its receptors:new pathways for co-stiumulation and inhibition of immunnerresponse[J].Annu Rev Immunol,2002,20 (5):29-35.
  • 7Lo AC,Saab CY,Black JA,et al.Phenytion protects spinal cord axons and preserves axonal conduction and neurological function in a model of neuroinflammation in vivo[J].Neurophysiol,2003,90(11):3566-3571.
  • 8Craner MJ,Newcombe J,Black JA,et al.Molecular changes in neurons in multiple sclerosis:altered axonal expression of Navi.2 and Navl.6 sodium channels and Na+/Ca2+ exchanger[J].Proc Natl Acad Sci USA,2004,101(21):8168-8173.
  • 9Wilmore DW,Kehlet H.Management of patients in fast track surgery[J].BMJ,2001,322(7284):473 -476.
  • 10Kehlet H,Wilmore DW.Multi-modal strategies to improve surgical outcome.Am J Surg,2002,183 (6):630-641.

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