快速康复外科对老年结直肠癌患者术后免疫功能的影响

摘要

Objective To investigate the influence of fast tract surgery on the immune function in aged patients with colorectal cancer. Methods 40 patients were randomized to control group(n=20) and FTS group(n=20).CRP,IgG,IgA,IgM,CD4+were tested before operation and postoperative day 3 and postoperative day 7. Results On the day 3,7 postoperatively,CRP significantly increased as compared to those preoperatively in two groups (P<0.05),but the parameters in control group were significantly higher than those in FTS group (P<0.05). On the day 3 postoperatively,IgG,IgA,IgM significantly decreased as compared with those preoperatively in two groups(P<0.05),and the parameters in control group were significantly lower than those in FTS group(P<0.05). On the day 7,there was no significant difference of IgG,IgA,IgM between before and after operation in FTS group(P>0.05) ,but the parameters in control group were significantly lower than those preoperatively. On day 3 postoperatively,CD 4 + significantly decreased as compared to those preoperatively in two groups (P<0.05),and the parameters in control group were significantly lower than those in FTS group(P<0.05). The levels of CD4+recovered rapidly in FTS group on the day 7 postoperatively(P>0.05),but the parameters in control group were significantly lower than those preoperatively (P<0.05). Conclusion Fast track surgery for aged patients with colorectal cancer can preserve immunity,and accelerates postoperative rehabilitation.%目的：观察快速康复外科( FTS)对老年结直肠癌根治手术患者机体免疫功能的影响。方法将40例老年结直肠癌患者随机分成两组，即对照组(20例)和FTS组(20例)。两组分别于术前、术后第3d和第7d取外周静脉血，测定C反应蛋白(CRP)、免疫球蛋白(IgG、IgA、IgM)以及CD4+等。结果两组患者术后第3和第7d CRP较术前均升高( P<0.05)，与FTS组对比，对照组升高更加明显(P<0.05)。两组患者免疫球蛋白于术后第3d较术前均明显降低(P<0.05)，与FTS组比，对照组降低更明显(P<0.05)，术后第7d，FTS组免疫球蛋白恢复至术前水平，而对照组仍明显低于术前(P<0.05)。两组患者术后第3d CD4+较术前明显降低( P<0.05)，与FTS组比，对照组降低更明显(P<0.05)，术后第7d，FTS组CD4+恢复至术前水平，而对照组仍明显低于术前(P<0.05)。结论老年结直肠癌患者应用FTS理念可保护免疫功能，加速患者术后康复。