Lu Cai-Ping, Gao Ying, Zhang Zhi-Hong
Department of Medicine, Henan Vocational University of Science and Technology, Zhoukou 466000, Henan Province, China.
Department of General Surgery, Zhoukou First People's Hospital, Zhoukou 466000, Henan Province, China.
World J Gastrointest Surg. 2025 May 27;17(5):103340. doi: 10.4240/wjgs.v17.i5.103340.
Gastric cancer predominantly affects the elderly, who face significant challenges due to high postoperative complications and stress. These challenges include comorbidities, reduced physiological reserves, and increased risks of infections and delayed healing. Traditional postoperative care often falls short in addressing these issues effectively. Enhanced recovery after surgery (ERAS) principles have revolutionized surgical care by reducing stress and promoting recovery through a holistic approach. ERAS emphasizes preoperative optimization, intraoperative care, and postoperative rehabilitation tailored to patient needs. Despite its recognized benefits, the impact of continuity nursing care within the ERAS framework on elderly gastric cancer patients remains underexplored. This study examines the influence of ERAS-based continuity nursing care on postoperative satisfaction, inflammation, stress, and quality of life in elderly patients undergoing gastric cancer resection.
To investigate the effects of ERAS-based continuity nursing care on postoperative satisfaction, inflammation, stress, and quality of life in elderly gastric cancer patients.
A retrospective cohort analysis was conducted on 322 elderly patients who underwent gastric cancer resection between January 2020 and January 2022. Patients were assigned to a routine care group ( = 156) or an ERAS-control (ERAS-C) group ( = 166). Data collected included demographic information, inflammatory and stress markers, satisfaction scores using the patient satisfaction questionnaire-18, and quality of life measured using the European Organization for Research and Treatment of Cancer 22-item quality of life questionnaire specific to gastric cancer.
The ERAS-C group exhibited significantly lower postoperative interleukin-6 levels than the routine care group (12.97 ± 4.02 pg/mL 14.37 ± 3.86 pg/mL; = 0.002). This finding indicates that the ERAS-C group experienced reduced inflammation. The ERAS-C group also had a higher cluster of differentiation (CD) 4:CD8 ratio than the routine care group (2.34 ± 0.35 2.13 ± 0.61; < 0.001), suggesting the former's enhanced immune response. Postoperative stress markers, including norepinephrine, cortisol, and aldosterone, were significantly lower in the ERAS-C group than in the routine care group ( < 0.05 for all). Compared with the routine care group, the ERAS-C group showed increased nursing satisfaction scores (80.36 ± 7.24 75.23 ± 7.03; < 0.001) and improved quality of life indicators, such as reduced dysphagia and pain, ( < 0.05). The ERAS-C group also experienced fewer complications than the routine care group (5.42% 11.54%, = 0.048).
Continuity nursing care within the ERAS framework significantly enhances postoperative outcomes for elderly gastric cancer patients by reducing inflammation, stress, and complications while improving satisfaction and quality of life.
胃癌主要影响老年人，他们因术后并发症多和压力大而面临重大挑战。这些挑战包括合并症、生理储备减少、感染风险增加和愈合延迟。传统的术后护理在有效解决这些问题方面往往不足。术后加速康复（ERAS）原则通过整体方法减轻压力并促进康复，彻底改变了外科护理。ERAS强调根据患者需求进行术前优化、术中护理和术后康复。尽管其益处已得到认可，但ERAS框架内的连续性护理对老年胃癌患者的影响仍未得到充分探索。本研究探讨基于ERAS的连续性护理对老年胃癌切除患者术后满意度、炎症、压力和生活质量的影响。
探讨基于ERAS的连续性护理对老年胃癌患者术后满意度、炎症、压力和生活质量的影响。
对2020年1月至2022年1月期间接受胃癌切除术的322例老年患者进行回顾性队列分析。患者被分为常规护理组（n = 156）或ERAS对照组（ERAS-C组，n = 166）。收集的数据包括人口统计学信息、炎症和压力标志物、使用患者满意度问卷-18的满意度评分，以及使用欧洲癌症研究与治疗组织针对胃癌的22项生活质量问卷测量的生活质量。
ERAS-C组术后白细胞介素-6水平显著低于常规护理组（12.97±4.02 pg/mL对14.37±3.86 pg/mL；P = 0.002）。这一发现表明ERAS-C组炎症减轻。ERAS-C组的分化簇（CD）4:CD8比值也高于常规护理组（2.34±0.35对2.13±0.61；P < 0.001），表明前者的免疫反应增强。ERAS-C组术后的压力标志物，包括去甲肾上腺素、皮质醇和醛固酮，均显著低于常规护理组（所有P < 0.05）。与常规护理组相比，ERAS-C组的护理满意度评分提高（80.36±7.24对75.23±7.03；P < 0.001），生活质量指标改善，如吞咽困难和疼痛减轻（P < 0.05）。ERAS-C组的并发症也比常规护理组少（5.42%对11.54%，P = 0.048）。
ERAS框架内的连续性护理通过减轻炎症、压力和并发症，同时提高满意度和生活质量，显著改善老年胃癌患者的术后结局。
