陈愉快 冯树开 徐托

【摘要】 目的：观察腹腔镜结肠癌切除术患者行快速康复与临床及生理稳态关系的相关性。方法：选择2018年8月-2020年2月在本院就诊的160例结肠癌患者作为研究对象，按照随机数字表法将其分为对照组和观察组，各80例。分别在围手术期采用常规治疗和快速康复外科治疗，比较两组临床及生理相关指标。结果：观察组患者禁食、肠鸣音恢复、首次排气时及首次排便时间均短于对照组，差异均有统计学意义（P<0.05）。术后，两组CRP、IL-6水平均升高，但观察组CRP、IL-6水平均低于对照组，差异均有统计学意义（P<0.05）。术后1、3、7 d，观察组胰岛素抵抗指数均低于对照组，差异均有统计学意义（P<0.05）。结论：腹腔镜结肠癌切除术患者行快速康复治疗，对于促进患者术后胃肠功能恢复、减少胰岛素抵抗作用显著，能够减轻炎性反应，值得临床借鉴。

【关键词】 腹腔镜结肠癌切除术 快速康复 胃肠功能 胰岛素抵抗

Study on the Rapid Rehabilitation and Relationship between Clinical and Physiological Homeostasis in Patients Undergoing Laparoscopic Colon Cancer Resection/CHEN Yukuai， FENG Shukai， XU Tuo. //Medical Innovation of China， 2021， 18（05）： -124

[Abstract] Objective： To observe the rapid rehabilitation and relationship between clinical and physiological homeostasis in patients undergoing laparoscopic colon cancer resection. Method： A total of 160 cases of colon cancer patients admitted to our hospital from August 2018 to February 2020 were selected as the research objects， they were divided into control group and observation group according to random number table method， 80 cases in each group. Routine treatment and rapid rehabilitation surgery were used in the perioperative period respectively， the clinical and physiological indicators of the two groups were compared. Result： The fasting， intestinal sound recovery， first exhaust and first defecation time in observation group were shorter than those in control group， the differences were statistical significance （P<0.05）. After surgery， the levels of CRP and IL-6 in both groups were increased， the levels of CRP and IL-6 in the observation group were lower than those in the control group， the differences were statistical significance （P<0.05）. The insulin resistance index of the observation group were lower than those of the control group at 1， 3 and 7 days after surgery， the differences were statistical significance （P<0.05）. Conclusion： The rapid rehabilitation treatment of patients with laparoscopic colon cancer resection can promote the recovery of gastrointestinal function， reduce insulin resistance， reduce inflammatory response， which is worthy of clinical reference.

[Key words] Laparoscopic colon cancer resection Rapid recovery Gastrointestinal function Insulin resistance

First-authors address： Yangdong District Peoples Hospital of Yangjiang City， Yangjiang 529500， China

doi：10.3969/j.issn.1674-4985.2021.05.031

腹腔鏡结肠癌切除术是临床治疗结肠癌的常见术式，该手术方式创伤小、出血量少，对于患者术后恢复、增强预后有着重要的意义[1-2]。然而作为一种创伤性活动，手术在一定程度上会给患者带来生理、心理创伤应激，导致胰岛素抵抗，增加并发症发生风险[3]。近年来，快速康复理念在外科手术治疗中得以渗透，围术期辅之以快速康复治疗，对于减轻手术应激有着重要的意义[4]。此次研究选取的160例腹腔镜结肠癌切除术病例，均为2018年8月-2020年2月在本院的就诊患者，旨在分析快速康复治疗与患者临床及生理稳态的关系，现报道如下。

1 资料与方法

1.1 一般资料 选取2018年8月-2020年2月于本院就诊的160例腹腔镜结肠癌切除术患者。纳入标准：（1）术前经肠镜及病理检查确诊为结直肠癌[5];（2）术前检查无肝脏、肺部、腹腔等远处转移;（3）患者术前无肠梗阻或重度营养不良。排除标准：（1）年龄>80岁;（2）术前行放化疗或新辅助化疗;（3）存在腹腔和/或盆腔手术史;（4）术中需中转开腹或行联合脏器切除;（5）存在严重器官功能障碍及任一系统疾病[6-8]。按……