Impact Of Perioperative Stress Response To Postoperative Recovery

Objective:The purpose of this study is to determine the impact of the varieties of perioperative stress response to the postoperative recovery.Method:Selecting 90 cases of patients in general surgery ward who would take selective of limited abdominal operations.One day before surgery and the 1st day after surgery drew fasting blood samples to assay blood glucose,CRP,IL-6,insulin,aldosterone and corticoid.Recording the possible factors that might impact postoperative recovery,and observing the occurrence of postoperative complications,flatus time,postoperative length hospitalization stay which relative to postoperative recovery.Screening the factors that impacted to postoperative recovery using univariate analysis,then bring them into the multivariate regression analysis model to observe the independent factor impacting to postoperative recovery.Result:(1) 31 patients Suffered postoperative complications out of the 90 patients.Multivariate logistic regression indicated that preoperative insulin(OR=0.73;p=0.02),postoperative IL-6 concentration(OR=1.01;p=0.03),ASA classification(OR=5.76;p=0.01) and malignant tumors(OR=6.34;p=0.01) were the independent factors impacting postoperative complications.(2) The average postoperative flatus time of the 90 patients was 55.0±30.6 hours. Multi-variate regression indicate that postoperative aldosterone(p＜0.01;β=0.08), blood loss(p＜0.01;β=0.07) and malignant tumor(p=0.02;β=16.89) are the independent factors that impact postoperative flatus time.(3) The average postoperative length hospital stay of the 90 patients was 15.9±11.7 days. Multivariate linear regression find that preoperative aldosterone(p＜0.01;β=0.98), postoperative blood glucose(p＜0.01;β=0.03)and incision length(p＜0.01;β=0.68)are the independent factors that impact postoperative length hospital stay. Conclusion:(1) Preoperative insulin,aldosterone levels and postoperative IL-6,aldosterone,blood glucose levels are relative to the postoperative recovery.So Fast Track Surgery that's aim is to reduces perioperative stress response has a advantage to postoperative recovery.(2) The patient's ASA classification,benign or malignant of patients' disease,surgical blood loss and incision length impact postoperative recovery.The last 2 factors may be relative to operative tress.So minimal invasive surgery which is known as minimal incision and small blood loss has a advantage to postoperative recovery.