CAJ | 학술논문

目的：观察快速康复外科( FTS)对老年结直肠癌根治手术患者机体免疫功能的影响。方法将40例老年结直肠癌患者随机分成两组，即对照组(20例)和FTS组(20例)。两组分别于术前、术后第3d和第7d取外周静脉血，测定C反应蛋白(CRP)、免疫球蛋白(IgG、IgA、IgM)以及CD4+等。结果两组患者术后第3和第7d CRP较术前均升高( P<0.05)，与FTS组对比，对照组升高更加明显(P<0.05)。两组患者免疫球蛋白于术后第3d较术前均明显降低(P<0.05)，与FTS组比，对照组降低更明显(P<0.05)，术后第7d，FTS组免疫球蛋白恢复至术前水平，而对照组仍明显低于术前(P<0.05)。两组患者术后第3d CD4+较术前明显降低( P<0.05)，与FTS组比，对照组降低更明显(P<0.05)，术后第7d，FTS组CD4+恢复至术前水平，而对照组仍明显低于术前(P<0.05)。结论老年结直肠癌患者应用FTS理念可保护免疫功能，加速患者术后康复。
목적：관찰쾌속강복외과( FTS)대노년결직장암근치수술환자궤체면역공능적영향。방법장40례노년결직장암환자수궤분성량조，즉대조조(20례)화FTS조(20례)。량조분별우술전、술후제3d화제7d취외주정맥혈，측정C반응단백(CRP)、면역구단백(IgG、IgA、IgM)이급CD4+등。결과량조환자술후제3화제7d CRP교술전균승고( P<0.05)，여FTS조대비，대조조승고경가명현(P<0.05)。량조환자면역구단백우술후제3d교술전균명현강저(P<0.05)，여FTS조비，대조조강저경명현(P<0.05)，술후제7d，FTS조면역구단백회복지술전수평，이대조조잉명현저우술전(P<0.05)。량조환자술후제3d CD4+교술전명현강저( P<0.05)，여FTS조비，대조조강저경명현(P<0.05)，술후제7d，FTS조CD4+회복지술전수평，이대조조잉명현저우술전(P<0.05)。결론노년결직장암환자응용FTS이념가보호면역공능，가속환자술후강복。
Objective To investigate the influence of fast tract surgery on the immune function in aged patients with colorectal cancer. Methods 40 patients were randomized to control group(n=20) and FTS group(n=20).CRP,IgG,IgA,IgM,CD4+were tested before operation and postoperative day 3 and postoperative day 7. Results On the day 3,7 postoperatively,CRP significantly increased as compared to those preoperatively in two groups (P<0.05),but the parameters in control group were significantly higher than those in FTS group (P<0.05). On the day 3 postoperatively,IgG,IgA,IgM significantly decreased as compared with those preoperatively in two groups(P<0.05),and the parameters in control group were significantly lower than those in FTS group(P<0.05). On the day 7,there was no significant difference of IgG,IgA,IgM between before and after operation in FTS group(P>0.05) ,but the parameters in control group were significantly lower than those preoperatively. On day 3 postoperatively,CD 4 + significantly decreased as compared to those preoperatively in two groups (P<0.05),and the parameters in control group were significantly lower than those in FTS group(P<0.05). The levels of CD4+recovered rapidly in FTS group on the day 7 postoperatively(P>0.05),but the parameters in control group were significantly lower than those preoperatively (P<0.05). Conclusion Fast track surgery for aged patients with colorectal cancer can preserve immunity,and accelerates postoperative rehabilitation.