CAJ | 학술논문

目的研究快速康复外科理念下食管癌手术患者应激因子的变化.方法选取食管癌患者85例,分别选择采取快速康复外科治疗方案(43例)作为试验组,采取传统治疗方案(42例)作为对照组,观察记录术前、术后1、3、5天血清中C-反应蛋白(CRP)、白介素-6(IL-6)、皮质醇(COR)数值变化.采用SPSS 13.0软件包进行统计学处理,定量数据采用x±s表示,检验方法采用t检验和四格表资料x2检验.P ＜0.05为差异有统计学意义.结果 (1)CRP:两组术前、术后1天比较差异均无统计学意义(P＞0.05),术后3、5天试验组较对照组均明显降低(P＜0.05);试验组术后5天已接近术前水平(P＞0.05),对照组术后5天与术前比较仍处于较高水平(P＜0.05).(2) IL-6:两组术前、术后1天比较差异均无统计学意义(P＞0.05),术后3、5天试验组较对照组均明显降低(P＜0.05);试验组术后5天已接近术前水平(P＞0.05),对照组术后5天与术前比较仍处于较高水平(P＜0.05).(3)COR:两组术前、术后1、3天比较差异均无统计学意义(P＞0.05),术后5天试验组较对照组明显降低(P＜0.05);试验组术后5天已接近术前水平(P＞0.05),对照组术后5天与术前比较仍处于较高水平(P＜0.05).结论试验组术后应激因子低于对照组,且试验组术后应激因子能较早恢复到术前水平,进一步证实快速康复外科理念能加速食管癌患者术后康复.
목적 연구쾌속강복외과이념하식관암수술환자응격인자적변화.방법 선취식관암환자85례,분별선택채취쾌속강복외과치료방안(43례)작위시험조,채취전통치료방안(42례)작위대조조,관찰기록술전、술후1、3、5천혈청중C-반응단백(CRP)、백개소-6(IL-6)、피질순(COR)수치변화.채용SPSS 13.0연건포진행통계학처리,정량수거채용x±s표시,검험방법채용t검험화사격표자료x2검험.P ＜0.05위차이유통계학의의.결과 (1)CRP:량조술전、술후1천비교차이균무통계학의의(P＞0.05),술후3、5천시험조교대조조균명현강저(P＜0.05);시험조술후5천이접근술전수평(P＞0.05),대조조술후5천여술전비교잉처우교고수평(P＜0.05).(2) IL-6:량조술전、술후1천비교차이균무통계학의의(P＞0.05),술후3、5천시험조교대조조균명현강저(P＜0.05);시험조술후5천이접근술전수평(P＞0.05),대조조술후5천여술전비교잉처우교고수평(P＜0.05).(3)COR:량조술전、술후1、3천비교차이균무통계학의의(P＞0.05),술후5천시험조교대조조명현강저(P＜0.05);시험조술후5천이접근술전수평(P＞0.05),대조조술후5천여술전비교잉처우교고수평(P＜0.05).결론 시험조술후응격인자저우대조조,차시험조술후응격인자능교조회복도술전수평,진일보증실쾌속강복외과이념능가속식관암환자술후강복.
Objective To investigate the change of stress indicators in patients with esophageal cancer under the concept of fast-track surgery.Methods 85 esophageal cancer patients were enrolled and assigned randomly to study group (fast-track surgery treatment,n =43) and control group(traditional treatment,n =42).Serum CRP,IL-6 and COR at different time spots(before surgery,Postoperative Day 1,3 and 5) were adopted as the indicators to judge effect in this study.Results (1) CRP:Preoperative CRP and the first day after surgery showed no significant difference between two groups (P ＞ 0.05).FTS group showed obvious lower CRP level from postoperative day 3 (P ＜ 0.05).On postoperative day 5,study group showed similar CRP level with preoperative(P ＞ 0.05),but the CRP level in control group was still higher compared to preoperative(P ＜0.05).(2)IL-6:Preoperative IL-6 and the first day after surgery showed no significant difference between two groups (P ＞0.05).FTS group showed obvious lower IL-6 level from day 3 (P ＜ 0.05).On postoperative day 5,study group showed similar IL-6 level with preoperative(P ＞ 0.05),but the IL-6 level in control group was still higher compared to preoperative (P ＜0.05).(3) COR:Preoperative COR,as well as the first day and the third day after surgery showed no significant difference between two groups(P ＞ 0.05).FTS group showed obvious lower COR on postoperative day 5 (P ＜ 0.05).On postoperative day 5,study group showed similar COR level with preoperative(P ＞ 0.05),but the COR level in control group was still higher compared to preoperative(P ＜0.05).Conclusion The level of stress indicators in the experimental group is lower than in the control group,and returns to baseline earlier.This study confirms that fast track surgery can accelerate the rehabilitation of patients with esophageal cancer postoperatively.