[1]丁春花,李颖颖.加速康复外科对行腹腔镜根治术老年结直肠癌患者的影响[J].新乡医学院学报,2022,39(8):781-785.[doi:10.7683/xxyxyxb.2022.08.016]
　DING Chunhua,LI Yingying.Effect of enhanced recovery after surgery on elderly patients with colorectal cancer undergoing laparoscopic radical resection[J].Journal of Xinxiang Medical University,2022,39(8):781-785.[doi:10.7683/xxyxyxb.2022.08.016]
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加速康复外科对行腹腔镜根治术老年结直肠癌患者的影响
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
39
期数:
2022年8
页码:
781-785
栏目:
护理研究
出版日期:
2022-08-05

文章信息/Info

Title:
Effect of enhanced recovery after surgery on elderly patients with colorectal cancer undergoing laparoscopic radical resection
作者:
丁春花1; 李颖颖2
（1.郑州大学第一附属医院，河南　郑州　450052；2.郑州大学第一附属医院胃肠外科/疝与腹壁外科，河南　郑州　450052）
Author(s):
DING Chunhua1; LI Yingying2
(1.The First Affiliated Hospital of Zhengzhou University，Zhengzhou 450052，Henan Province，China；2.Gastrointestinal，Hernia and Abdominal Surgery，the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052，Henan Province，China)
关键词:
结直肠癌; 结直肠癌根治术; 腹腔镜手术; 加速康复外科
Keywords:
colorectal cancer; colorectal cancer radical surgery; laparoscopic operation; enhanced recovery after surgery
分类号:
R735.3
DOI:
10.7683/xxyxyxb.2022.08.016
文献标志码:
A
摘要:
目的　探讨加速康复外科（ERAS）对行腹腔镜根治术老年结直肠癌（CRC）患者的影响。方法　选择2019年1月至2020年10月郑州大学第一附属医院收治的113例老年CRC患者为研究对象，所有患者拟行择期腹腔镜根治术，根据围手术期干预方法将患者分为观察组（n=57）和对照组（n=56）。围手术期，对照组患者给予常规临床干预，观察组患者给予ERAS方案干预。记录2组患者术前、术中30 min及术后的心率（HR）、收缩压（SBP）和舒张压（DBP）；分别于术前和术后第1 天检测患者血清P物质（SP）、5-羟色胺（5-HT）和前列腺素E2（PGE2）水平；术前和术后第7天检测患者血清总蛋白（TP）、白蛋白（Alb）和前白蛋白（PAB）水平。结果　2组患者术前HR、SBP和DBP比较差异均无统计学意义（P>0.05）。对照组患者术中和术后HR、SBP和DBP显著高于术前（P<0.05）；观察组患者术中SBP、DBP显著高于术前（P<0.05），观察组患者术后与术前SBP、DBP比较差异无统计学意义（P>0.05）；观察组患者术前、术中及术后HR比较差异均无统计学意义（P>0.05）。观察组患者术中和术后HR、SBP和DBP均显著低于对照组（P<0.05）。2组患者术前血清SP、5-HT和PGE2水平比较差异无统计学意义（P>0.05），2组患者术后血清SP、5-HT和PGE2水平均显著高于术前（P<0.05），术后观察组患者血清SP、5-HT和PGE2水平显著低于对照组（P<0.05）。2组患者术前血清TP、Alb和PAB水平比较差异无统计学意义（P>0.05），2组患者术后血清TP、Alb和PAB水平显著低于术前（P<0.05），术后观察组患者血清TP、Alb和PAB水平均显著高于对照组（P<0.05）。结论　ERAS可以有效稳定行腹腔镜结直肠癌根治术老年患者的HR和血压，降低患者血清疼痛介质水平，改善患者营养状况。
Abstract:
Objective　To investigate the effect of enhanced recovery after surgery (ERAS) on elderly patients with colorectal cancer (CRC) undergoing laparoscopic radical resection.Methods　A total of 113 elderly CRC patients admitted to the First Affiliated Hospital of Zhengzhou University from January 2019 to October 2020 were selected as the research subjects.All patients were scheduled to undergo elective laparoscopic radical resection，and the patients were divided into observation group (n=57) and control group (n=56) according to the perioperative intervention methods.During the perioperative period，the patients in the control group were given routine clinical intervention，and the patients in the observation group were given ERAS program intervention.The heart rate (HR)，systolic blood pressure (SBP) and diastolic blood pressure (DBP) of patients in the two groups were recorded before operation，30 minutes during operation and after operation.The levels of serum substance P (SP)，5-hydroxytryptamine (5-HT) and prostaglandin E2 (PGE2) were detected before surgery and on the first day after surgery.The levels of serum total protein (TP)，albumin (Alb) and prealbumin (PAB) were detected before surgery and on the seventh day after surgery.Results　There was no significant difference in preoperative HR，SBP and DBP of patients between the two groups (P>0.05).The HR，SBP and DBP during and after operation were significantly higher than those before operation in the control group (P<0.05).The intraoperative SBP and DBP of patients in the observation group were significantly higher than those before operation (P<0.05).There was no significant difference in SBP and DBP of patients between postoperative and preoperative patients in the observation group (P>0.05).There was no significant difference in HR before，during and after operation in the observation group (P>0.05).The HR，SBP and DBP of patients in the observation group were significantly lower than those in the control group during and after operation (P<0.05).There was no significant difference in serum SP，5-HT and PGE2 levels of patients between the two groups before operation (P>0.05).The levels of serum SP，5-HT and PGE2 of patients after operation were significantly higher than those before operation in the two groups (P<0.05).The levels of serum SP，5-HT and PGE2 of patients in the observation group were significantly lower than those in the control group after operation (P<0.05).There was no significant difference in the levels of serum TP，Alb and PAB of patients between the two groups before operation (P>0.05).The levels of serum TP，Alb and PAB of patients after operation were significantly lower than those before operation in the two groups (P<0.05).The levels of serum TP，Alb and PAB of patients in the observation group were significantly higher than those in the control group after operation (P<0.05).Conclusion　　ERAS can effectively stabilize the HR and blood pressure of elderly patients undergoing laparoscopic radical resection of colorectal cancer，reduce the levels of serum pain mediators，and improve the nutritional status of patients.

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更新日期/Last Update: 2022-08-05