The Research Of The Intestinal Function And Autonomic Nervous Regulation In Enhanced Recovery After Surgery (ERAS)

Objective Use Heart rate variability to monitor Enhanced recovery after Surgery perioperative autonomic nervous system regulation to reflect intestinal motor function indirectly, and research the mechanism of ERAS combined with neuroendocrine changes.Methods In this research we strict filter 60 cases of colon cancer patients from 2014-01 to 2015-12. They will divided into Group A (ERAS group n=30) and Group B(Conventional control group n=30) randomly. Group A implements ERAS perioperative treatment scheme, and Group B was given Conventional perioperative treatment scheme, both two groups will be operated laparoscopic colon surgery. Serum inflammatory cytokines will be detected by blood biochemical tests and autonomic nervous system regulation changes will monitor with portable heart rate variability apparatus adopting 5mines-Short definitions data collection method. At last, we combine both of clinical, laboratory, and heart rate variability to analysis of the results the mechanism of ERAS.Results 1.Clinical indicators:The catheter removal time were 1.51±1.30d and 3.66±1.23d(P<0.05), peritoneal drainage tube removal time were 3.14±0.82d and 6.83±1.70d(P<0.05).first postoperative ventilation time were 1.86±0.94d and2.53±1.13d(P<0.05).first postoperative ambulation time were 1.91 ±1.31d and 2.38±0.82d(P<0.05), first semi-liquid diet time were 1.16±0.64d and 3.02±1.33d(P<0.05), postoperative hospital stay time were 5.63±2.35d and 9.41±3.74d. ERAS group all the clinical indicators are better than conventional control group.2.Serological laboratory indicators:preoperative 12h CRP were 1.58±2.23 and 1.32±4.33 ng/L(P>0.05), postoperative 12h CRP were 60.23±56.28 and 83.26±40.52 ng/L(P<0.05), postoperative 72h CRP were 55.67±46.33 and 72.67±47.14 ng/L(P<0.05); preoperative 12h IL-6 were 4.53±1.42 and 3.67±1.32 ng/L(P>0.05). postoperative 12h IL-6 were 13.10±10.08 and 19.29±13.06 ng/L(P<0.05), postoperative 72h IL-6 were 2.38±2.64 and 3.47±2.34 ng/L(P<0.05). ERAS group inflammation was less than conventional control group.3.Heart rate variability indictors:preoperative 12h SDNN were 147.22±13.88 and 140.12±18.83 (P>0.05), postoperative 12h SDNN were 78.41±9.82 and 60.12±7.78 (P<0.05), postoperative 72h SDNN were 123.3±15.71 and 100.78±8.98 (P<0.05); preoperative 12h LF/HF were 1.1±0.3 and 1.3±0.4(P>0.05), postoperative 12h LF/HF were 4.8±0.5 and 2.5±0.5(P<0.05), postoperative 72h LF/HF were 3.1±1.1 and 1.9±0.8(P<0.05). ERAS group perioperative autonomic nervous system stimulation received was slight than conventional control group.Conclusions Heart rate variability can reflect ERAS perioperative autonomic nervous system regulation changes, combined with clinical indicators and serological laboratory indicators expound why could ERAS promote the rehabilitation of patients after surgery from neurohumoral regulation aspects.