摘要
目的:观察加速康复外科(fast track surgery,FTS)联合腹腔镜技术对结直肠癌根治术后患者营养指标的影响。方法:将92例结直肠癌患者随机分为3组,Ⅰ组(n=31)应用传统围手术期处理行开腹手术,Ⅱ组(n=31)在FTS理念指导下行开腹手术,Ⅲ组(n=30)在FTS理念指导下行腹腔镜手术。3组患者分别于术前、术后第3天、术后第7天抽取外周血测定C反应蛋白(CRP)、白蛋白(ALB)、前白蛋白(PRE)、转铁蛋白(TRF)、视黄醇结合蛋白(RbP)、血红蛋白(Hb)等。结果:3组患者术后第3天、第7天CRP较术前均明显升高(P<0.01),与Ⅱ组、Ⅲ组相比,Ⅰ组患者术后第3天、第7天CRP升高更明显(P<0.01),与Ⅲ组相比,Ⅱ组升高明显(P<0.05)。术后第3天3组患者ALB、PRE、TRF、RbP、Hb水平均较术前明显减低,与Ⅱ组、Ⅲ组相比,Ⅰ组减低更明显;与Ⅲ组相比,Ⅱ组PRE、TRF、Hb降低更明显(P<0.05)。术后第7天,Ⅰ组各项指标仍低于术前(P<0.05),较第3天升高(P<0.05);Ⅱ组各项指标较术后第3天有所升高(P<0.05),且较Ⅰ组升高明显(P<0.05);Ⅲ组患者PRE、TRF、Hb恢复至术前水平,其他指标较术后第3天升高明显(P<0.05)。结论:应用FTS理念行腹腔镜结直肠手术,可更有效缓解术后炎症反应,维持患者术后营养状态,对术后患者康复具有积极作用。
Objective：To investigate the influence of fast tract surgery on the nutritional status after laparoscopic colorectal resections in cancer patients. Methods： Ninty-two patients were randomized to receive traditional protocol and open surgery（ group I ,n = 31 ） , fast track protocols and open surgery （ group II , n = 31 ）, fast track surgery and laparoscopic surgery （ group Ⅲ, n = 30）. CRP, ALB, PRE, TRF, RbP, Hb were tested before operation and after operation for 3 and 7 days. Results ： On the day 3,7 postoperatively, CRP sig- nificantly increased as compared to those preoperatively in three groups（ P 〈 0.01 ） ,hut the parameters in group I were significantly higher than those in group II and m （ P 〈 0.01 ）, and the parameters in group ]] were significantly higher than those in group m （P 〈 0. 05） ; On the day 3 postoperatively, ALB, PRE,TRF, RbP, Hb significantly decreased as compared with those preoperatively in three groups（P 〈 0.05 ） ,and the parameters in group I were significantly lower than those in group II and m （P 〈 0. 01 ）. PRE,TRF, Hb in group II significantly decreased as compared with those in group III （ P 〈 0.05 ）. On the day 7 postoperatively, the parameters in group I were significantly lower than those preoperatively, but the parameters significantly increased as compared with those. On the day 3 postoperatively （P 〈 0.05 ）, the parameters in group II were significantly higher than those in group I （P 〈 0.05 ）and On the day 3 postoperatively （P 〈 0.05） ,the level of PRE,TRF, Hb in group m recovered rapidly on the day 7 postoperatively （P 〉 0.05 ）, the level of PRE and RbP significantly increased as compared with those On the day 3 postoperatively （P 〈 0.05）. Conclusions ： Fast track surgery could effectively mitigates the inflammatory response and nutritional impairment of colorectal cancer patients after laparoscopic colorectal resection, and accelerates postoperative rehabilitation.
出处
《腹腔镜外科杂志》
2012年第12期899-902,共4页
Journal of Laparoscopic Surgery
