| 摘要: |
| 目的探讨快速康复外科（FTS）在肝癌肝切除患者围术期的临床应用效果及对细胞免疫功能的影响。方法选取择期行肝癌肝切除术患者48例，按随机数字表法分为FTS组与常规组，各24例，比较两组患者术后肝功能、细胞免疫功能及临床疗效指标。结果两组患者临床基线资料比较差异均无统计学意义（均P＞0.05）。术后第３天，FTS组TBil为（113.96±61.39）μmol/L，ALT为（146.17±72.51）U/L，AST为（155.04±54.04）U/L；常规组TBil为（165.25±64.38）μmol/L，ALT为（213.46±107.48）U/L，AST为（225.92±81.51）U/L，两组比较差异均有统计学意义（均P＜0.05）；FTS组CD3+、CD4+、CD4+/CD8+指标均明显优于常规组（均P＜0.05）。FTS组患者术后首次肛门排气时间、首次进半流质时间、首次排便时间均较常规组提前（均P＜0.05），术后住院时间亦缩短（P＜0.05）。结论FTS理念用于肝癌肝切除术患者围术期处理可降低患者术后应激反应、提高术后细胞免疫功能，改善患者术后肝功能恢复效果、缩短术后肛门排气时间和住院时间，安全性好，加快患者康复，值得临床应用。 |
| 关键词: 快速康复外科 肝切除术 免疫功能 |
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| Application of fast track surgery in perioperative management for patients with hepatic cancer |
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Zhong Hai, Zhou Chunhui, Huang Yanhua, Kong Fanchuang, Wang Xiaoguang
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Jiaxing Second Municipal hospital
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| Abstract: |
| Objective To evaluate the clinical application of fast track surgery in perioperative management for patients with hepatic cancer. Methods Forty eight patients with hepatic cancer undergoing hepatic surgery in Jiaxing Second Hospital were were randomly divided into the fast track surgery group (FTS group, n=24) and the traditional operation group (control group, n=24).The liver function indexes，T cell subsets and clinical effect were compared between two groups. Results There were no significant differences in baseline parameters between two groups (P ＞0.05). Three days after operation, the total bilirubin (113.96 ±61.39 μmol/L vs. 165.25 ±64.38μmol/L, P＜0.05), glutamic oxalacetic transaminase (146.17 ±72.51U/L vs. 213.46 ± 107.48U/L, P ＜0.05) and alanine aminotransferase (155.04 ±54.04U/L vs. 225.92 ±81.51U/L, P ＜0.05) in FTS group were significantly lower than those in control group. The indexes of CD3+, CD4+ and CD4+/CD8+ in FTS group were significantly higher than those in control group (P＜0.05). The FTS group showed faster resumption of oral intake, quicker bowel function return, earlier
first defecation and shorter hospital stay than control group (all P ＜0.05). Conclusion Fast track surgery in perioperative management is feasible for patients with hepatic cancer，which can reduce the stress reaction, increase postoperative immune function, improve liver function, shorten anal exhaust time and length of stay, promote the rehabilitation, and it is worthy of clinical application． |
| Key words: Fast track surgery Hepatectomy Immune function |
