| 摘要: |
| 目的:探讨加速康复外科( ERAS)对腹腔镜胆囊切除术患者术后全身炎症应激状态及康复质量的影响。方法:选取 2017年 1月—2019年 1月间我院收治的胆囊息肉患者 110例，经随机数表法将其分为对照组、 ERAS组各 55例。对照组患者接受围术期常规干预， ERAS组接受围术期 ERAS干预。对比两组患者的术后炎症反应及氧化应激反应程度及康复情况差异。结果:术后 24 h，ERAS组患者血清中炎症因子白介素 -6(IL-6)、白介素 -8(IL-8)、白介素 -35(IL-35)的水平低于对照组患者；氧化应激指标氧自由基( ROS)、丙二醛(MDA)的水平低于对照组患者，超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶( GSH-Px)的水平高于对照组患者( P＜ 0.05)。术后 48 h，两组患者的炎症因子、氧化应激指标水平的差异无统计学意义( P＞ 0.05)。ERAS组患者的术后排气时间、住院时间短于对照组患者；术后切口疼痛、恶心呕吐发生率低于对照组患者( P＜ 0.05)。两组术后肺部感染、下肢静脉血栓发生率的差异无统计学意义( P＞ 0.05)。两组术后无一例发生腹腔出血。结论:ERAS可有效减轻腹腔镜胆囊切除术患者术后近期的炎症及应激反应，加速机体康复并一定程度上减少术后并发症发生。 |
| 关键词: 腹腔镜胆囊切除术 加速康复外科 炎症反应 氧化应激反应 康复质量 |
| DOI：10.3969/j.issn.1007-6948.2020.01.020 |
| 投稿时间：2019-04-21 |
| 基金项目: |
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| Effects of Enhanced Recovery after Surgery on Postoperative Systemic Inflammatory Stress State and Rehabilitation Quality of Patients Undergoing Laparoscopic Cholecystectomy |
| YANG Wei-gang |
| Department of General Surgery, Changxing Country People’s Hospital, the Second Af.liated Hospital of Zhejiang Medical University, Changxing 313100, China |
| Abstract: |
| Objective To investigate the effect of enhanced recovery after surgery (ERAS) on systemic inflammatory stress and rehabilitation quality after laparoscopic cholecystectomy. Methods Totally 110 patients with gallbladder polyps admitted to our hospital during January 2017 to January 2019 were randomly divided into control group and ERAS group, with 55 cases in each group. Patients in control group were treated with routine perioperative intervention, while those in ERAS group were treated with perioperative ERAS intervention. The degree of inflammatory reaction, oxidative stress reaction and rehabilitation were compared between two groups. Results After 24 h of operation, the serum levels of in.ammatory factors (IL-6, IL-8 and IL-35) in ERAS group were lower than those in control group; the levels of oxygen free radicals (ROS) and malondialdehyde (MDA) in ERAS group were lower than those in control group, and the levels of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) were higher than those in control group (P<0.05). After 48 h of operation, there was no signi.cant difference in levels of in.ammatory factors and oxidative stress indexes between two groups (P>0.05). Postoperative exhaust time and hospitalization time in ERAS group were shorter than those in control group, incision pain, nausea and vomiting incidence in ERAS group were lower than those in control group (P<0.05). There was no significant difference in the incidence of pulmonary infection and lower extremity venous thrombosis between two groups (P>0.05). No abdominal hemorrhage occurred in either group. Conclusion ERAS can effectively alleviate the short-term inflammation and stress reaction after laparoscopic cholecystectomy, accelerate the recovery of the body and reduce the occurrence of complications to a certain extent. |
| Key words: Laparoscopic cholecystectomy accelerated rehabilitation surgery inflammatory reaction |
