【摘要】 目的观察快速康复外科对腹腔镜胃癌根治术患者机体免疫功能和营养状态的影响。方法回顾性分析2015年7月至2017年5月该院收治的行腹腔镜胃癌根治术患者76例,其中快速康复路径组(观察组)34例和常规治疗组(对照组)42例,抽取术前、术后第3天及第7天外周静脉血,分析比较两组免疫功能指标:免疫球蛋白(Ig G、Ig A、Ig M)、T淋巴亚群(CD4+、CD8+)以及营养状况指标[血清清蛋白(ALB)、前清蛋白(PAB)、转铁清蛋白(TRF)]的差异。结果 (1)两组患者术前各指标比较,差异无统计学意义(P>0.05)。(2)与术前相比,术后第3天两组免疫球蛋白均降低,且对照组降低更明显,差异有统计学意义(P<0.05);术后第7天观察组免疫球蛋白恢复至术前水平,而对照组仍低于术前。(3)两组患者术后第3天CD4+、CD8+、CD4+/CD8+较术前均明显降低,对照组降低更明显,差异均有统计学意义(P<0.05);术后第7天,观察组CD4+、CD8+、CD4+/CD8+基本恢复至术前水平,而对照组仍低于术前,差异有统计学意义(P<0.05)。(4)两组患者术后第3天血清ALB、PAB、TRF水平均明显下降,差异有统计学意义(P<0.05),术后第7天有所上升,且观察组术后第3、7天血清ALB、PAB、TRF水平明显高于对照组,差异有统计学意义(P<0.05)。结论快速康复外科相较传统方法能明显改善胃癌患者术后的免疫功能及营养状态,加速患者术后康复,在预防肿瘤远期转移复发中具有积极作用。更多还原

【Abstract】 Objective To investigate the effect of fast track surgery(FTS)on the immune function and nutritional status in the patients with gastric cancer laparoscopic radical operation. Methods Seventy-six cases of gastric cancer laparoscopic radical operation admitted and treated in this hospital from July 2015 to May 2017 were retrospectively analyzed,including34 cases in the FTS group(observation group)and 42 cases in the routine treatment group(control group).Peripheral venous blood was collected before operation and on postoperative 3,7 d. The immune function indexes of immunoglobulin(Ig G,Ig A,Ig M)and T-lymphocyte subsets(CD4+,CD8+),nutritional status indicators of serum albumin(ALB),prealbumin(PAB)and transferrin albumin(TRF)were analyzed and compared between the two groups. Results(1)The preoperative various indicators had no statistical difference between the two groups(P>0.05).(2)Compared with before operation,the immunoglobulin levels in the two groups were decreased,moreover the decrease in the control group was more significant,the difference was statistically significant(P<0.05);the immunoglobulin levels on postoperative 7 d in the observation group recovered to the preoperative level,while which in the control group was still lower than the preoperative levels(P<0.05).(3)Compared with before operation,CD4+,CD8+ and CD4+/CD8+ on postoperative 3 d in the two groups were significantly decreased,moreover the decrease in the control group was more significant,the difference was statistically significant(P<0.05);CD4+,CD8+ and CD4+/CD8+ on postoperative 7 d in the observation group were basically recovered to preoperative levels,but which in the control group were still lower than preoperative levels,the difference was statistically significant(P<0.05).(4)The serum ALB,PAB and TRF levels on postoperative 3 d in the two groups were significantly decreased,the difference was statistically significant(P<0.05),which on postoperative 7 d were somewhat increased,moreover the serum ALB,PAB and TRF levels on postoperative 3,7 d in the observation group were significantly higher than those in the control group,the difference was statistically significant(P<0.05). Conclusion FTS can significantly improve the postoperative immune function and nutritional status in the patients with gastric cancer,accelerates the postoperative recovery,and also plays a positive role in preventing long term tumor metastasis and recurrence.更多还原