快速康复外科对甲状腺癌患者围手术期恢复、应激指标及吞咽功能的影响
Effects of fast track surgery on perioperative recovery, stress indicators and swallowing function in patients with thyroid cancer.
作者信息
Chen Junjing, Huang Xiaoqing, Li Feifei
机构信息
Department of Hepatobiliary Surgery, Huzhou Central Hospital, Zhejiang University Huzhou Hospital, Affiliated Hospital of Huzhou Normal University Huzhou 313000, Zhejiang, China.
出版信息
Am J Transl Res. 2022 Oct 15;14(10):7109-7118. eCollection 2022.
OBJECTIVE
To explore the effects of fast track surgery (FTS) on perioperative recovery, stress indicators and swallowing function in patients with thyroid cancer.
METHODS
One hundred and thirty patients with thyroid cancer admitted to Huzhou Central Hospital, Zhejiang University Huzhou Hospital, Affiliated Hospital of Huzhou Normal University from January 2019 to December 2020 were retrospectively included as study subjects, and were divided into a control group (n = 63, conventional nursing) and a study group (n = 67, FTS). The perioperative recovery indicators, complications, stress response, and swallowing function were compared between the two groups. Logistic regression analysis was used to analyze the risk factors for accelerating postoperative recovery.
RESULTS
No statistically significant differences were observed in the scores of Kubota drinking test and Ichiro Fujishima rating scale (IFRS) between the two groups before intervention ( > 0.05). After nursing, the study group had lower scores of Kubota drinking test and higher scores of IFRS than the control group ( < 0.05). The time to drainage tube removal, time to first anal exhaust, time to first getting out of bed activity, length of hospitalization, and medical costs in the study group were lower than those in the control group ( < 0.05). The study group showed lower incidence of postoperative complications than the control group (8.96% vs. 28.57%, < 0.05). The postoperative C-reactive protein, glucose, epinephrine, cortisol levels and numerical rating scale scores in the study group were lower than those in the control group ( < 0.05). Logistic regression analysis showed that age was an important negative factor for accelerating postoperative recovery of patients with thyroid cancer, and the length of postoperative hospital stay increased significantly with age ( < 0.05).
CONCLUSION
The intervention of FTS in the perioperative period for thyroid cancer patients can improve the swallowing function, shorten the recovery time and reduce the incidence of complications, which may be related to the improvement of the perioperative stress response of patients with FTS.
目的
探讨快速康复外科（FTS）对甲状腺癌患者围手术期恢复、应激指标及吞咽功能的影响。
方法
回顾性纳入2019年1月至2020年12月在浙江大学湖州医院附属湖州师范学院附属医院湖州市中心医院收治的130例甲状腺癌患者作为研究对象，分为对照组（n = 63，常规护理）和研究组（n = 67，FTS）。比较两组围手术期恢复指标、并发症、应激反应及吞咽功能。采用Logistic回归分析甲状腺癌患者术后加速康复的危险因素。
结果
干预前两组间久保田饮水试验评分及藤岛一郎评级量表（IFRS）评分比较，差异无统计学意义（> 0.05）。护理后，研究组久保田饮水试验评分低于对照组，IFRS评分高于对照组（< 0.05）。研究组引流管拔除时间、首次肛门排气时间、首次下床活动时间、住院时间及医疗费用均低于对照组（< 0.05）。研究组术后并发症发生率低于对照组（8.96% vs. 28.57%，< 0.05）。研究组术后C反应蛋白、血糖、肾上腺素、皮质醇水平及数字评定量表评分均低于对照组（< 0.05）。Logistic回归分析显示，年龄是甲状腺癌患者术后加速康复的重要负性因素，术后住院时间随年龄增长显著增加（< 0.05）。
结论
FTS对甲状腺癌患者围手术期进行干预，可改善吞咽功能，缩短恢复时间，降低并发症发生率，这可能与FTS改善患者围手术期应激反应有关。
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