快速康复外科对老年胃癌患者的疗效及术后免疫功能的影响

摘要

目的 探究快速康复外科在老年胃癌治疗过程中的应用并分析对疗效、免疫水平的影响.方法 选择2015年1月至2016年6月在本院接受治疗的老年胃癌患者86例,以数字法随机分为观察组和对照组各43例.观察组采用快速康复外科进行治疗,对照组采用常规康复治疗.对比两组手术情况以及术前、术后细胞免疫水平、炎性水平以及脏器受损水平.结果 观察组手术时间[(142.46±31.24) min]、术中出血量[(85.06±19.32) ml]、术后肛门排气时间[(1.49±0.48)d]、住院时间[(16.47±4.96)d]均显著低于对照组(P＜0.05).两组在术前细胞免疫、炎性指标以及脏器指标相关水平比较差异均无统计学意义(均P＞ 0.05).术后观察组的细胞免疫水平中CD4+[(38.12±6.84)％]、CD4+/CD8+[(1.53±0.63)]高于对照组,而CD8+水平[(28.56±5.95)％]低于对照组(P＜0.05).观察组炎性指标中的C-反应蛋白(CRP)[(46.07±13.63) mg/L]、TNF-α[(40.17±10.23) ng/L]、IL-6[(26.29±6.06)ng/L]以及脏器指标中的GOT([41.56±4.05) U/L]、SCr[(131.45±41.96)μmol/L]、BNP[(278.94±57.84)ng/L]水平均显著低于对照组(均P＜ 0.05).结论 快速康复外科在老年胃癌手术中的应用能有效降低对主要脏器的损伤程度,同时对机体的免疫水平有明显提高,显著降低了手术时间及术后恢复时间,具有较高的应用价值.%Objective To explore the application of fast track surgery in the treatment of elderly patients with gastric cancer,and to analyze the effect on the curative effect and the immune level.Methods 86 elderly patients with gastric cancer treated in our hospital from January 2015 to June 2016 were randomly divided into observation group and control group with digital method,43 cases in each group.The observation group was treated by fast track surgery,while the control group was treated with routine rehabilitation.Compared the operation of two groups,cellular immune level,inflammatory level,and organ damage level before and after operation.Results The operation time [(142.46±31.24)min],bleeding volume [(85.06± 19.32)ml],postoperative anal exhaust time [(1.49±0.48)d],and hospitalization time [(16.47±4.96)d] in the observation group were significantly lower than those in the control group (P＜0.05).There were no statistically significant differences in preoperative cellular immunity,inflammatory index,and organ index between the two groups (P＞0.05).After operation,the levels of CD4+/CD8+ [(1.53±0.63)] and CD4+ [(38.12±6.84)％] in the observation group were higher than those in the control group,while the level of CD8+ [(28.56±5.95)％] was lower than that in the control group (P＜0.05);the levels of CRP [(46.07±13.63)mg/L],TNF-α[(40.17±10.23)ng/L],IL-6 [(26.29±6.06)ng/L],GOT [(41.56±4.05)U/L],SCr [(131.45±41.96)pmol/L],BNP [(278.94±57.84)ng/L] in the observation group were significantly lower than those in the control group (P＜0.05).Conclusions Fast track surgery in elderly patients with gastric cancer can effectively reduce the damage to the main organs,while has a significant role in improving the immune level of the body,and significantly reduce the operation time and postoperative recovery time,with high application value in clinic.