快速康复外科理念应用对卵巢癌患者围手术期炎症和应激反应的影响

摘要/Abstract

摘要： 目的：观察快速康复外科理念应用对卵巢癌患者围手术期炎症和应激反应的影响。方法：选择2018年1月至2019年12月于我院诊断为卵巢癌的患者96例作为研究对象，按照随机数字法将患者分为观察组和对照组，每组48例。对照组围手术期予以常规处理，观察组在对照组的基础上予以快速康复外科理念处理。比较两组患者术后临床指标和并发症发生率，比较两组患者术后1 d和术后5 d血清糖链抗原125（CA125）、胰岛素样生长因子1 （IGF-1）、磷酸化应激诱导蛋白1（STIP-1）、可溶性细胞间黏附因子-1（sICAM-1）、可溶性血管细胞黏附分子-1（sVCAM-1），可溶性髓系细胞触发受体-1（sTREM-1）、促肾上腺皮质激素（ACTH）、去甲肾上腺素（NE）和皮质醇（Cor）水平的变化。结果：观察组患者术后排气时间、下床活动时间、排便时间、输液治疗时间和住院时间均短于对照组（P<0.01）。观察组患者并发症发生率为8.33%，低于对照组的27.08%（χ2=4.575，P<0.05）。两组患者术前和术后1 d血清CA125、IGF-1、STIP-1、sICAM-1、sVCAM-1、sTREM-1、ACTH、NE和Cor水平差异均无统计学意义（P>0.05），术后5 d两组患者以上指标水平较术前、术后1 d均降低（P<0.01），且观察组患者降低幅度更为明显（P<0.01）。结论：快速康复外科理念应用于卵巢癌患者，有助于提高疗效，降低术后并发症，可能与降低机体炎症反应和应激反应有关。

关键词: font-size:medium, ">快速康复外科理念；卵巢癌；围手术期；炎症；应激反应

Abstract: Objective： To observe the application effect of the concept of fast track surgery（FTS） on perioperative inflammation and stress response in ovarian cancer patients. Methods： 96 patients with ovarian cancer diagnosed in our hospital from January 2018 to December 2019 were divided into the observation group and the control group according to random number method， 48 cases in each group. The control group was given routine treatment during the perioperative period， and the observation group was treated with FTS concept on the basis of the control group. The postoperative clinical indicators and complications were observed in the two groups. The cancer antigen 125 (CA 125)， insulin-like growth factor 1 (IGF-1)， stress-induced phosphorprotein 1(STIP-1)， soluble intercellular adhesion molecde-1 (sICAM-1)， soluble vascular cell adhesion molecule-1 (sVCAM-1)， soluble triggering receptor expressed on myeloid cells-1 (sTREM-1)， adrenocorticotropic hormone (ACTH)， norepinephrine (NE) and cortisol (Cor) levels were also compared in the two groups before surgery and at 1 d and 5 d after surgery. Results： The postoperative exhaust time， out of bed time， defecation time， infusion treatment time and hospital stay time in the observation group were shorter than those in the control group (P <0.01). The complication rate was 8.33% in the observation group， which was lower than 27.08% in the control group (χ2=4.575， P<0.05). There was no significant difference in serum CA125， IGF-1， STIP-1， sICAM-1， sVCAM-1， sTREM-1， ACTH， NE and Cor levels between the two groups before surgery and at 1 d after surgery (P>0.05)， the levels of the avove indicators at 5 d after surgery in the two groups were lower than those at 1 d after surgery in the two groups(P<0.01)， and the decrease levels in the observation group were move obviously compared with the control group (P<0.01). Conclusion： The FTS concept applied to patients with ovarian cancer can help to improve the treatment efficacy and reduce postoperative complications， which may be related to reducing the body′s inflammatory response and stress response.

Key words: font-size:medium, ">Fast track surgery concept； Ovarian cancer； Perioperative period； Inflammation； Stress response

中图分类号:

孙姗姗, 王秋梅, 王蓓莉, 刘晓庆. 快速康复外科理念应用对卵巢癌患者围手术期炎症和应激反应的影响[J]. 中国医药导刊, 2021, 23(1): 11-15.

SUN Shanshan, WANG Qiumei, WANG Beili, LIU Xiaoqing. The Application Effect of Fask Track Surgery Concept on Perioperative Inflammation and Stress Response in Patients with Ovarian Cancer[J]. CHINESE JOURNAL OF MEDICINAL GUIDE, 2021, 23(1): 11-15.

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