Application of accelerated rehabilitation surgery on elderly patients with gastric cancer and its effects on inflammation and nutritional indicators / 中国基层医药

ABSTRACT

Objective To analyze the application of accelerated rehabilitation surgery in elderly patients with gastric cancer surgery and its influence on inflammation and nutritional indicators .Methods From October 2017 to October 2018,80 elderly patients with gastric cancer who underwent gastrectomy in Shaoxing People ＇s Hospital were selected.According to random number table method ,they were randomly divided into traditional control group and ERAS group, with 40 cases in each group.The traditional control group was treated by traditional perioperative treatment +operation,while ERAS group was treated with ERAS perioperative treatment +operation.The recovery and complications, inflammation and nutritional changes before operation , 1 day after operation and 3 days after operation,and the improvement of quality of life after operation were compared and analyzed between the two groups . Results In the ERAS group,the first exhaust time[(2.3 ±0.8)d] and defecation time[(2.5 ±0.4)d]were shorter than those in the traditional control group [(3.5 ±0.5)d and (3.7 ±0.6)d],and the incidence rate of complications (7.5%) was lower than that in the traditional control group (35.0%),the differences were statistically significant (t＝8.72,10.52,χ2 ＝9.04,all P ＜0.05).On the first day after operation ,the serum levels of tumor necrosis factor-alpha (TNF-α) and interleukin -6(IL-6) in the ERAS group were (28.3 ±4.9) μg／L and (23.1 ± 5.8)μg／L,respectively,which were lower than those in the traditional control group [(39.8 ±6.7)μg／L and (34.5 ± 8.1)μg／L](t＝8.76,7.24,all P＜0.05).The serum TNF-αand IL-6 levels in the ERAS group on the 3rd day after operation were (18.4 ±6.2) μg／L and (18.3 ±3.2) μg／L,respectively,which were lower than those in the traditional control group[(26.2 ±5.1)μg／L and (26.5 ±4.8) μg／L] ( t＝6.14,8.99,all P＜0.05).The serum levels of albumin (Alb) and prealbumin (PRE) in the ERAS group on the first day after operation were (31.1 ± 0.7)g／L and (161.3 ±7.2) mg／L,respectively,which were lower than those in the traditional control group [(30.2 ± 0.9)g／L and (154.3 ±4.8)mg／L](t＝4.99,5.12,all P＜0.05).The serum levels of Alb and PRE in the ERAS group on the 3rd day after operation were (33.4 ±0.5)g／L and (172.1 ±5.0)mg／L,respectively,which were lower than those in the traditional control group [(31.9 ±0.8) g／L and (165.3 ±3.2) mg／L] (t＝10.06,7.24,all P＜0.05).The WHOQOL-BREF score of the ERAS group[(91.4 ±6.5)points]was higher than that of the traditional control group[(80.3 ±7.8)points](P＜0.05).Conclusion Accelerated rehabilitation surgery has good effect for elderly gastric cancer surgery.It can maintain the inflammation and nutritional status of patients after operation .It is worthy of clinical reference.