Huang Yanqi, Chen Feiying, Li Haizhen
Dental Department, Zhuji People's Hospital of Zhejiang Province Zhuji 311800, Zhejiang, China.
Internal Medicine-Cardiovascular Department, The Second People's Hospital of Huai'an Huai'an 223002, Jiangsu, China.
Am J Transl Res. 2022 Nov 15;14(11):8156-8165. eCollection 2022.
To explore the effect of rapid rehabilitation nursing on inflammation and liver function in patients with primary liver cancer (PLC) after laparoscopic radical resection.
A total of 124 PLC patients who underwent laparoscopic radical surgery in the Zhuji People's Hospital of Zhejiang Province from April 2019 to July 2021 were enrolled in this retrospective study. Among them, 65 patients who received rapid rehabilitation nursing were assigned into the observation group (OG), and the other 59 with routine nursing were considered to be the control group (CG). The pain before operation (T0), 3 days after operation (T1) and 7 days after operation (T2) was evaluated by visual analogue scale (VAS). The perioperative related indexes and nursing satisfaction were compared. The levels of liver function indexes alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL) and inflammatory factors C-reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were measured before operation, 1 day and 7 days after operation. Finally, the incidence of postoperative complications was counted, the 6-month survival rate of both groups of patients was compared.
There was no obvious difference in VAS scores between the two groups at T0 (P>0.050), but the VAS scores at T1 and T2 in the OG were lower than those in the CG (P<0.001). There was no marked difference in the total operation time. Compared with the CG, the time to first exhaust, catheter indwelling and hospitalization in the OG were shorter (P<0.001) and the nursing satisfaction rate was higher (P<0.05). There was no obvious difference in ALT, AST and TBIL on the 1st day after operation (P>0.05); however, on the 7th day after operation, ALT and AST were lower while TBIL was higher in the OG (all P<0.05). There was no marked difference in CRP, IL-6 and TNF-α between the two groups on postoperative day 1 (P>0.05), but the levels were lower in the OG than those in the CG on postoperative day 7 (all P<0.05), and the total incidence of adverse reactions in the OG was lower (P<0.05). There was no statistical difference in the postoperative survival rate between both groups of patients (P>0.05). Age, number of lesions, tumor size, Child-Pugh grade, AST, TBIL, CRP, IL-6, TNF-α were associated with the survival rate of patients.
Rapid rehabilitation nursing can effectively reduce adverse reactions after laparoscopic radical resection of PLC. Thus, it has a high application value in future clinical treatment.
探讨快速康复护理对原发性肝癌（PLC）患者腹腔镜根治性切除术后炎症及肝功能的影响。
选取2019年4月至2021年7月在浙江省诸暨市人民医院行腹腔镜根治性手术的124例PLC患者纳入本回顾性研究。其中，65例接受快速康复护理的患者被分配到观察组（OG），另外59例接受常规护理的患者被视为对照组（CG）。采用视觉模拟评分法（VAS）评估术前（T0）、术后3天（T1）和术后7天（T2）的疼痛情况。比较围手术期相关指标及护理满意度。检测术前、术后1天和术后7天肝功能指标谷丙转氨酶（ALT）、谷草转氨酶（AST）、总胆红素（TBIL）及炎症因子C反应蛋白（CRP）、白细胞介素-6（IL-6）和肿瘤坏死因子-α（TNF-α）的水平。最后，统计术后并发症的发生率，比较两组患者的6个月生存率。
两组在T0时VAS评分无明显差异（P>0.050），但观察组在T1和T2时的VAS评分低于对照组（P<0.001）。总手术时间无显著差异。与对照组相比，观察组首次排气时间、留置导尿管时间和住院时间更短（P<0.001），护理满意度更高（P<0.05）。术后第1天ALT、AST和TBIL无明显差异（P>0.05）；然而，术后第7天，观察组ALT和AST较低，而TBIL较高（均P<0.05）。两组术后第1天CRP、IL-6和TNF-α无显著差异（P>0.05），但观察组术后第7天这些指标水平低于对照组（均P<0.05），且观察组不良反应总发生率较低（P<0.05）。两组患者术后生存率无统计学差异（P>0.05）。年龄、病灶数量、肿瘤大小、Child-Pugh分级、AST、TBIL、CRP、IL-6、TNF-α与患者生存率相关。
快速康复护理可有效降低PLC患者腹腔镜根治性切除术后的不良反应。因此，其在未来临床治疗中具有较高的应用价值。
