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腹腔镜结直肠癌根治术的手术时段对患者术后康复的影响
Effect of different periods of laparoscopic radical resection for colorectal cancer on rehabilitation: report of 190 cases
- 陆军军医大学学报 2023年45卷第4期 页码：301-306
- 作者机构：
1.400038 重庆，陆军军医大学(第三军医大学)第一附属医院：麻醉科
2.400038 重庆，陆军军医大学(第三军医大学)第一附属医院：普外科
3.400038 重庆，陆军军医大学(第三军医大学)第一附属医院：肿瘤科
- 作者简介：
[甯交琳，E-mail：njiaolin1976@126.comNING Jiaolin, E-mail: njiaolin1976@126.com
- 基金信息：国家自然科学基金面上项目(82270095)
DOI：10.16016/j.2097-0927.202207165
中图分类号： R181.23;R615;R735.35收稿：2022-07-25，
修回：2022-10-19，
纸质出版：2023-02-28
- 稿件说明：
移动端阅览
杨思琦, 段家翔, 李小东, 等. 腹腔镜结直肠癌根治术的手术时段对患者术后康复的影响[J]. 陆军军医大学学报, 2023,45(4):301-306.
Siqi YANG, Jiaxiang DUAN, Xiaodong LI, et al. Effect of different periods of laparoscopic radical resection for colorectal cancer on rehabilitation: report of 190 cases[J]. Journal of Army Medical University, 2023, 45(4): 301-306.
杨思琦, 段家翔, 李小东, 等. 腹腔镜结直肠癌根治术的手术时段对患者术后康复的影响[J]. 陆军军医大学学报, 2023,45(4):301-306. DOI： 10.16016/j.2097-0927.202207165.
Siqi YANG, Jiaxiang DUAN, Xiaodong LI, et al. Effect of different periods of laparoscopic radical resection for colorectal cancer on rehabilitation: report of 190 cases[J]. Journal of Army Medical University, 2023, 45(4): 301-306. DOI： 10.16016/j.2097-0927.202207165.
摘要
目的
2
探讨不同手术时间段的腹腔镜结直肠癌根治术患者术后康复情况的差异。
方法
2
采用回顾性队列研究设计方案，筛选2020年10月至2021年9月于我院行腹腔镜结直肠癌根治术的190例患者病例资料，根据手术麻醉开始的时间分为两组：上午(8:00~12:00)手术组(
n
=98)和下午(14:00~18:00) 手术组(
n
=92)。分析比较两组患者手术时间、麻醉时间、麻醉拔管时间、术中出血量、术后首次进食时间、术后首次排气和排便时间、术前与术后外周血免疫细胞计数、术后炎症指标、并发症发生率、住院天数和费用等指标。
结果
2
下午手术组术后未发生任何并发症的患者多于上午手术组患者(
P
=0.023)，并且术后进食时间更早(
P
=0.012)；下午手术组患者术后白细胞(white blood cell，WBC)、中性粒细胞(neutrophil，Neu)较术前显著增加，术后淋巴细胞(lymphocytes，Lym)较术前显著减少(
P
<
0.01)。其术后中性粒细胞与淋巴细胞比值(neutrophil to lymphocytes ratio，NLR)、血小板与淋巴细胞比值(platelet to lymphocytes ratio，PLR)和全身免疫炎症指数(systemic immune inflammation index，
SII)明显高于上午手术组患者(
P
<
0.001)，而住院时间及费用等组间比较差异均无统计学意义。
结论
2
下午接受腹腔镜结直肠癌根治术患者并发症少、进食早，术后近期康复更佳。
Abstract
Objective
2
To investigate the effect of different periods of laparoscopic radical resection for colorectal cancer on rehabilitation in patients.
Methods
2
A retrospective cohort study was conducted on 190 patients who accepted laparoscopic radical resection of colorectal cancer in our hospital from October 2020 to September 2021. The patients were divided into 2 groups according to the starting time of the operation: the morning(8:00~12:00) operation group (
n
=98) and the afternoon (14:00~18:00) operation group (
n
=92). The indicators were compared between 2 groups
including the duration of operation and anesthesia
the time of extubation
the volume of intraoperative blood loss
the first time of food intake
the first anal exhaust time
the first defecation time
preoperative and postoperative immune peripheral blood cells count
postoperative immune-inflammation indexes
the incidence of complications
length of stay and costs.
Results
2
The afternoon surgery group had increased patients without complications and earlier first time of food intake of patients
compared with the morning surgery group(
P
=0.023
P
=0.012). After the surgery
white blood cell(WBC) and neutrophil (Neu) counts in the afternoon surgery group significantly increased
while lymphocytes (Lym) significantly decreased (
P
<
0.01). Neutrophil to lymphocytes ratio (NLR)
platelet to lymphocytes ratio(PLR) and systemic immune inflammation index(SII) in the afternoon surgery group were significantly higher than those in the morning surgery group(
P
<
0.001). There was no significant difference in length of stay and cost (
P
>
0.05).
Conclusion
2
The patients undergoing laparoscopic radical resection for colorectal cancer in the afternoon have fewer complications
earlier first time of food intake and better short-term rehabilitation.
关键词
Keywords
references
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