ABSTRACT
Objective:To explore the application of enhanced recovery around surgery (CMERAS) by integrated Traditional Chinese Medicine & western medicine in perioperative period of laparoscopic anterior resection for rectal cancer patients.Methods:100 patients with rectal cancer who were treated by laparoscopic anterior resection in Shuguang Hospital from July 2017 to July 2019 were divided into two groups with random number table method, 50 patients in each group. The control group received enhanced recovery after surgery (ERAS) perioperative treatment and the observation group received CMERAS perioperative treatment. Both groups were treated for 7 days. The degree of intestinal cleansing during the operation and postoperative rehabilitation quality were observed of the two groups, including the time of first exhaust, hospitalization time and the incidence of complications. Serum CRP level was detected by immunoturbidimetry, serum IL-6 level was detected by chemiluminescence immunoassay and peripheral blood CD4, CD8 and CD4/CD8 were detected by flow cytometry. Adverse reactions were recorded for the two groups.Results:There was no significant difference in the degree of intestinal cleansing between the two groups during operation ( Z=-1.140, P=0.254). The first postoperative exhaust time in the observation group (29.7 ± 4.6 h vs. 36.1 ± 3.8 h, t=7.590) was earlier than that of the control group, the hospitalization time (4.2 ± 0.5 d vs. 4.7 ± 0.6 d, t=4.379) was less than that of the control group, and the incidence of complications [8.0% (4/50) vs. 30.0% (15/50), χ2=6.498] was lower than that of the control group ( P<0.01). On the third day after the operation, serum CRP (11.84 ± 4.69 mg/L vs. 23.63 ± 5.04 mg/L, t=12.106) and IL-6 (34.31 ± 5.93 ng/L vs. 44.39 ± 8.81 ng/L, t=6.714) in the observation group were lower than those in the control group ( P<0.05). CD4 levels [(37.74 ± 7.28)% vs. (33.55 ± 5.07)%, t=-3.344], CD4/CD8 ratio (1.36 ± 0.27 vs. 1.13 ± 0.22, t=-4.920) were higher than those in the control group ( P<0.01), and CD8 levels [(28.04 ± 4.68)% vs. (30.22 ± 4.04)%, t=2.487] was lower than that of the control group ( P<0.05). There were no adverse reactions in two groups during the treatment. Conclusion:CMERAS could promote the perioperative recovery of patients with rectal cancer if treated with laparoscopic anterior resection and fewer complications would occur.
ABSTRACT
ObjectiveTo observe the effect of combined acupuncture-medication anesthesia on visceral function of patients undergone laparoscopic cholecystectomy, and to furtherexplore its clinical and theoretical significance.MethodSixty patients who were going to receive laparoscopic cholecystectomy were enrolled and randomized into an observation group (combined acupuncture-medication anesthesia) and a control group (conventional general anesthesia) by the random number table, 30 subjects in each group. The total bilirubin (TBIL), alanine aminotransferase (ALT), aspertate aminotransferase (AST), urea nitrogen, creatinine, and Mini-Mental State Examination (MMSE) were observed to evaluate the effect of combined acupuncture-medication anesthesia on visceral function of patients undergone laparoscopic cholecystectomy.ResultBefore operation, there were no significant differences in TBIL, ALT, urea nitrogen, creatinine, and MMSE between the observation group and the control group (P>0.05), while the AST level of the observation group was significantly higher than that of the control group before operation(P0.05); the TBIL level in the observation group was significantly lower than that in the control group (P0.05). The MMSE score of the observation group was significantly higher than that of the control group 6 h after the operation (P0.05).ConclusionThe combined acupuncture-medication anesthesia and conventional general anesthesia play equal effects on liver and kidney functions in laparoscopic cholecystectomy, thus the two anesthesia methods are both safe andeffective. The combined acupuncture-medication anesthesia has certain protective effects on brain function in early stage, and possibly produces certain protective effectson liver function.