Effects Of Enhanced Recovery After Surgery On Stress Reaction In Patients Undergoing Laparoscopic Partial Hepatectomy

Objective:To observe the effects of enhanced recovery after surgery on stress reaction in patients undergoing laparoscopic partial hepatectomy.Methods:Sixty patients(ASA I or II,age 36~60 years)whom were taken laparoscopic hepatectomy were randomly divided to two groups: group ERAS and group CT,30 cases in each group.Recorded the heart rate(HR),mean arterial pressure(MAP),pulse oxygen saturation(SPO2)of each patient at the moment into the examination room(T0)?one hour after surgery began(T1),immediately after the operation(T2),four hours after surgery(T3).The blood samples were collected from the ulnar vein at the T0~T3 points,then cortisol(Cor)? angiotensin-II(A-II)? interleukin-6(IL-6)?interleukin-10(IL-10)? tumor necrosis factor-?(TNF-?)? ?-endorphin(?-EP)?malondialdehyde(MDA)were measured.The recovery time of postoperative,the postoperative visual analogue scale(VAS)value,the bruggrmann comfort scale(BCS),dizziness,nausea and vomiting,the infection of incisional wound,average hospitalization days were recorded.Results::Compared with T0,?-EP and CVP in group ERAS of T2?T3,A-II in group ERAS of T2,?-EP?CVP?A-II in group CT of T1~T3,Cor?IL-6?IL-10?TNF-a?MDA in two group of T1~T3 were increased(P<0.05);compared with group CT,MDA?TNF-a in group ERAS of T3,A-II in group ERAS of T2,?-EP in group ERAS of T1?T2,Cor?IL-6?CVP in group ERAS of T1~T3 were decreased(P<0.05).IL-10 in group ERAS of T3 were increased(P<0.05).Compared with group CT,the rate of dizziness ?nausea were occurred smaller(P < 0.05).The recovery time of postoperative,the postoperative VAS value is lower(P <0.05).The general information ? incisional wound,average hospitalization days in two groups has no significant difference(P>0.05).Conclusion:The application of enhanced recovery after surgery in laparoscopic partial hepatectomy can effectively reduce the stress reaction and reduce the release of inflammatory cytokines.