快速康复外科理念对结直肠癌合并糖尿病患者术后应激反应及血糖水平影响.docVIP

快速康复外科理念对结直肠癌合并糖尿病患者术后应激反应及血糖水平的影响 　　[摘要] 目的 ?^察围术期应用快速康复外科理念（FTS）对结直肠癌合并糖尿病患者应激反应及血糖水平的影响。 方法 选取2013年6月～2016年6月在秦皇岛市第二医院行经腹结直肠癌根治术合并糖尿病患者124例。根据围术期处理方法不同，将患者分为对照组（60例）和观察组（64例）。对照组给予常规围术期处理，观察组给予FTS理念指导下的围术期处理。观察两组患者术后首次排便时间、肛门排气时间及进半流食时间，比较手术前后两组患者的应激反应[C反应蛋白（CRP）、白介素6（IL-6）、皮质醇（Cor）]和空腹血糖（FPG）水平。 结果 观察组患者术后排便时间、肛门排气时间、进半流食时间均短于对照组，差异有统计学意义（P 0.05），术后两组血清CRP、IL-6、Cor、FPG水平差异有高度统计学意义（P 0.05）外，其他指标同组患者手术前后差异均有高度统计学意义（P 0.01）。 结论 采用FTS理念对结直肠癌合并糖尿病患者进行围术期处理，可以减轻患者的应激反应，降低血糖水平，从而促进患者尽快康复。 　　[关键词] 结直肠癌；糖尿病；快速康复外科；围术期 　　[中图分类号] R473.6 [文献标识码] A [文章编号] 1673-7210（2017）10（a）-0069-05 　　[Abstract] Objective To explore the influence of fast track surgery （FTS） on stress reaction and blood glucose level in the perioperative patients with colorectal cancer and diabetes mellitus. Methods A total of 124 patients with colorectal cancer and diabetes mellitus， who were admitted in the Second Hospital of Qinhuangdao from June 2013 to June 2016 were selected. All patients were divided into the control group （60 cases） and the observation group （64 cases） according to the perioperative treatment. The patients in the control group were performed with routine perioperative treatment， while the patients in the observation group were given FTS perioperative treatment. The defecation time， anal exhaust time， time of wallowing half-solid food in the two groups after operation were observed. And the stress reaction indexes （CRP， IL-6， Cor） and fasting blood glucose （FPG） level in the two groups before and after the operation were compared. Results The defecation time， anal exhaust time， time of wallowing half-solid food in the observation group were significantly shorter than those in the control group （P 0.05）， but after operation there were statistically significant differences between the two groups （P 0.05）， compared with before surgery of the above indicators， there were also significant differences in each group on postoperative 1 and 3 day（P 0.01）. Conclusion FTS concept used