目的：探讨快速康复外科对行开腹手术结直肠癌患者免疫功能和脂类水平的影响。方法收集本院结直肠癌行手术治疗患者128例，均行开腹手术，随机分为观察组（快速康复外科围手术期处理）和对照组（常规围手术期处理），每组各64例。对比两组患者术前、术后7 d 和术后28 d 的外周血淋巴细胞各亚群变化，免疫球蛋白水平和脂类水平的变化。结果术前两组患者各指标的比较中差异无显著性（P >0.05）。术后7 d，观察组 CD4+百分比、CD4/ CD8水平和 IgM 水平均明显高于对照组，差异具有显著性（P <0.05）；两组CD8+百分比和 IgG 水平比较差异无显著性（P >0.05）。术后28 d，观察组 CD4+百分比、CD4/ CD8水平、IgM水平和脂类水平明显高于对照组，且差异具有显著性（P <0.05）；两组患者 CD8+百分比和 IgG 水平比较差异无显著性（P >0.05）。结论快速康复外科能够降低开腹手术方式对患者免疫功能和脂类水平的影响，促进患者免疫功能和脂类物质水平的恢复。%Objective To explore the effects of fast track surgery on postoperative immune function and lipid levels in patients with colorectal cancer. Methods 128 patients with colorectal cancer who underwent laparotomy colorectal resection were randomly assigned into observation group(fast track surgery,n = 64)and control group(con-ventional treatment,n = 64). Changes of peripheral blood lymphocyte subgroups,immunoglobulin and lipid levels were compared in both groups before operation,7 d after operation and 28 d after operation. Results There were no signifi-cant differences between two groups before operation(P > 0. 05). The percentage of CD4 + ,levels of CD4 / CD8 and IgM in observation group were significantly higher than those in control group 7 days after operation(P < 0. 05). There was no significant difference in percentage of CD8 + and level of IgG(P > 0. 05). The percentage of CD4 + ,level of CD4 / CD8,IgM and lipid in observation group were significantly higher than those in control group 28 days after opera-tion(P < 0. 05). There was no significant difference in percentage of CD8 + and level of IgG(P > 0. 05). Conclusion Fast track surgery can decrease the effects of ways of laparotomy on immune function and lipid levels and accelerate the recovery of immune function and lipid levels.
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