加速康复外科对远端胃癌根治术后患者炎症反应和免疫功能的影响.docVIP

精品论文 参考文献 加速康复外科对远端胃癌根治术后患者炎症反应和免疫功能的影响 韩述岭 秦嘉若 (南方医科大学南方医院广东广州510515) 基金来源：南方医院院长基金（编号：2008C014）。 作者简介：韩述岭,医学博士,从事普通外科工作。 【摘要】目的：该研究应用加速康复外科新理念，观察对远端胃癌根治术后炎症反应和免疫功能的影响。方法：将46例远端胃癌手术病人随机分为两组，研究组(FTS组)病人应用加速康复外科治疗，对照组病人应用传统围手术期处理方法。观察两组病人术后首次肠道通气时间、术后住院时间和并发症，并于术前1天、术后第1天和第3天检测病人外周血清中IL-6、CRP、CD3、CD4、CD8和CD4/CD8比值。结果：FTS组与对照组比，术后住院时间显著缩短(Plt;0.05)；术后首次排气时间显著提前(Plt;0.05)；而术后并发症两者无显著差异。FTS组与对照组比，术后第1、3天外周血中CRP和IL-6浓度均有显著下降(Plt;0. 05)；CD4/CD8比值均有显著增加(Plt;0.05)。结论：应用加速康复外科能缓解远端胃癌手术病人的术后炎症反应，保护术后细胞免疫功能，促进病人快速康复。 【关键词】加速康复外科；胃癌；细胞免疫；炎症反应 【中图分类号】R459.3【文献标识码】B【文章编号】1008-6455（2010）08-0124-02The impact of fast track surgery on host cell-mediated immunity and inflammatory responses in patients after gastrectomy for gastric cancer Han ShulingQin Jiaruo 【Abstract】Objective：The aim of this study was to evaluate the impact of fast track surgery on host cell-mediated immunology and inflammatory responses in patients after gastrectomy for gastric cancer.　Methods：forty-six gastric cancer patients were prospectively divided into fast track surgery (FTS)group (n=23) and conventional perioperative care group (n=23). In addition to clinical parameters (recovery of gastrointestinal function，postoperative length of stay and complication rates)，the parameters of perioperative cell-mediated immunology function，and the serum level changes of CRP and IL-6 were determined. Results：FTS group was associated with a significantly shorter postoperative hospital stay compared with conventional care group (Plt;0.05). Serum concentration of CRP and IL-6 in FTS group were lower(Plt;0.05) than in the conventional care group on postoperative day(POD)1 and POD 3(Plt;0.05).CD4/CD8 ratio in FTS group were higher (Plt;0.05) than in the conventional care group on postoperative day (POD)1 and POD 3(Plt;0. 05).　Conclusion：Fast track surgery for gastric cancer patients can preserve cell-mediated immunity and control inflammatory responses when compared with conventional postoperative care. 【Key words】Fast track