【摘要】 目的：探讨加速康复外科（ERAS）理念干预联合经自然腔道取标本手术（NOSES）治疗左半结肠癌患者的效果。方法：选取2021年1月—2022年5月安徽医科大学附属安庆第一人民医院收治的65例左半结肠癌患者作为研究对象。根据随机分组原则将其分为传统组（n=32）和试验组（n=33）。传统组采用ERAS理念干预联合腹腔镜手术治疗，试验组采用ERAS理念干预联合NOSES治疗。比较两组围手术期指标，术前、术后2 d、4 d炎症因子，并发症。结果：两组手术时间及术中出血量比较，差异无统计学意义（P>0.05）；试验组首次排气时间、首次排便时间、流食时间均早于传统组，住院时间短于传统组，差异有统计学意义（P<0.05）。术后2 d，两组肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、超敏C反应蛋白（hs-CRP），白细胞计数（WBC）水平均较术前上升，术后4 d，两组hs-CRP、IL-6、WBC、TNF-α水平较术后2 d降低，术后2 d、4 d，试验组hs-CRP、IL-6、WBC、TNF-α水平均低于传统组，差异有统计学意义（P<0.05）。试验组并发症发生率（9.09%）低于传统组（31.26%），差异有统计学意义（P<0.05）。结论：ERAS理念干预联合NOSES可调节左半结肠癌患者血清炎症因子水平，缩短住院时间，减少并发症的发生。更多还原

【Abstract】 Objective: To explore the effect of enhanced recovery after surgery(ERAS) concept intervention combined with natural orifice specimen extraction surgery(NOSES) in the treatment of left colon cancer patients. Method: Sixty-five patients with left colon cancer admitted to Anqing First People’s Hospital Affiliated to Anhui Medical University from January 2021 to May 2022 were selected as the study objects. According to the random grouping principle, they were divided into traditional group(n=32) and experimental group(n=33). The traditional group was treated with ERAS concept intervention combined with laparoscopic surgery, and the experimental group was treated with ERAS concept intervention combined with NOSES. Perioperative indexes, inflammatory factors before surgery, 2 d and 4 d after surgery and complications were compared between the two groups. Result: There were no significant differences in surgery time and intraoperative blood loss volume between the two groups(P>0.05). The first exhaust time and first defecation time, liquid feeding time of experimental group were earlier than those of traditional group, and the hospital stay was shorter than that of traditional group,the differences were statistically significant(P<0.05). At 2 d after surgery, tumor necrosis factor-α(TNF-α), interleukin-6(IL-6),hypersensitive C-reactive protein(hs-CRP) and white blood cell count(WBC) levels increased in both groups compared with before surgery, and 4 d after surgery, hs-CRP, IL-6, WBC and TNF-α levels decreased in both groups compared with 2 d after surgery, at 2 d and 4 d after surgery, the levels of hs-CRP, IL-6, WBC and TNF-α in experimental groups were lower than those in traditional group,and the differences were statistically significant(P<0.05). The incidence of complication of experimental group(9.09%) was lower than that of traditional group(31.26%), and the difference was statistically significant(P<0.05). Conclusion: ERAS concept intervention combined NOSES can regulate serum inflammatory factor levels in patients with left colon cancer, shorten hospital stay and reduce the occurrence of complications.更多还原