| OBJECTIVE This study aims to observe the effect of enhanced recovery after surgery(ERAS)on gastric cancer patients' inflammatory response and immune function after radical operation.METHODS 81 patients who underwent radical gastrectomy of stomach neoplasms from February 2017 to September 2017 in our hospital were selected,and they were randomly divided into two groups,40 cases in the enhanced recovery after surgery experience group(ERAS group)and 41 cases in the conventional group(control group).The control group was treated with conventional treatment measures,while the ERAS group was treated with enhanced recovery after surgical treatment.The data of the resume eating time,the first exhaust time,the first defecation time,the ambulation time,the ideal postoperative hospitalization time and the actual postoperative hospitalization time were collected and analyzed in two groups of patients.The levels of inflammatory markers(serum CRP and PCT),complement(C3 and C4),humoral immune indexes(Ig G,Ig A and Ig M)and cellular immune indexes(CD3+,CD4+ and CD8+ T lymphocytes)in two groups were detected and compared.SPSS 20.0 statistical software package was used to process the date.The difference between groups was compared by t test.The difference of classification data was compared with the ?2 test,and P<0.05 thought that the difference was statistically significant.RESULTS The time of resume eating,the first time of exhaust,the time of first defecation,the time of ambulation and the time of idea hospitalization after the operation in the ERAS group were all lower than those of the control group,and the difference was statistically significant(P<0.001).Comparison of serum CRP and PCT levels of the two groups of patients before surgery,there was no statistically significant difference(P>0.05).In the first day after operation,serum CRP and PCT levels of ERAS group were significantly lower than the control group(P<0.05),and serum CRP and PCT of two groups were higher than the preoperative level(P<0.01).In the fourth day after operation,serum CRP and PCT levels of ERAS group were still less than that of the control group(P<0.05),and the serum CRP and PCT levels of two groups were higher than before(P<0.01).In the seventh day after operation,the serum level of PCT of ERAS group was significantly lower than the normal group(P<0.05),and serum CRP and PCT levels of two groups were higher than before(P<0.01).Comparison of Ig G,Ig A and Ig M levels of the two groups of patients before surgery,there was no statistically significant difference(P >0.05).In the first day after operation,the Ig G and Ig A levels of ERAS group were significantly higher than the control group(P<0.05),and the Ig G,Ig A,Ig M levels of two groups were significantly decreased compared with the preoperative(P<0.05).In the fourth days after operation,the Ig G and Ig A level of ERAS group was still higher than the control group(P<0.05).The Ig G and Ig M levels of ERAS group were significantly decreased(P<0.01),and the Ig G,Ig A and Ig M levels of control group were significantly decreased(P<0.05).In the seventh days after operation,the Ig G,Ig A and Ig M levels of ERAS group and the control group were no statistically significant difference(P>0.05).The Ig G and Ig M levels of control group are still lower than the preoperative(P<0.05),but only the Ig G level of the ERAS group was decreased(P<0.05).Comparison of complement C3,C4 levels of the two groups of patients before surgery,there was no statistically significant difference(P>0.05).In the first days after operation,the complement C3 and C4 levels of two groups were significantly decreased(P<0.05).In the fourth days after operation,only the complement C3,C4 level of the control group were significantly decreased(P<0.05).The CD3+ T lymphocyte,CD4+ T lymphocyte and CD8+ T lymphocyte percentage comparison of two groups of patients before and after surgery was no statistically significant difference(P>0.05).In the first days after operation,the CD3+ T lymphocyte,CD4+T lymphocyte and CD8+ T lymphocyte percentage of two groups were significantly decreased(P<0.05).In the fourth days after operation,the percentage of CD4+ T lymphocytes of ERAS group decreased significantly compared with the preoperative(P<0.01),while the CD3+ T lymphocyte,CD4+ T lymphocyte and CD8+ T lymphocyte percentage of the control group were significantly decreased(P<0.05).In the seventh days after operation,the CD3+ T lymphocyte,CD4+ T lymphocyte and CD8+ T lymphocyte percentage of two groups recovered and even exceeded the level before surgery.CONCLUSION The application of enhanced recovery after surgery in the perioperative management of gastric cancer can alleviate the postoperative inflammatory response,protect the postoperative complement system,promote the recovery of postoperative immune function and accelerate the recovery of patients after operation,which is worthy of extensive application in clinical. |
PDF Full Text Request