目的 探讨快速康复方案在继发性甲状旁腺功能亢进患者中的应用效果.方法 选取2020年1月至2023年6月于河北医科大学第三医院行甲状旁腺切除术治疗的200例继发性甲状旁腺功能亢进患者为研究对象,按照随机数字表法将其分为观察组与对照组,各100例.观察组给予快速康复策略,对照组给予常规护理.比较两组手术时间、住院时间、术后卧床时间、住院费用.比较两组不同时间点C反应蛋白(CRP)、白细胞介素-1(IL-1)、转化生长因子-β1(TGF-β1)、血钙、视觉模拟评分法(VAS)评分、医学研究理事会评估表(MRC)评分、体重指数.结果 两组手术时间比较,差异无统计学意义(P＞0.05);观察组住院时间、术后卧床时间短于对照组,住院费用低于对照组,差异有统计学意义(P＜0.05).两组术后1、3、5 d CRP、IL-1、TGF-β1水平均高于术前,术后3、5 d CRP、IL-1、TGF-β1水平低于术1 d,术后5 d CRP、IL-1、TGF-β,水平低于术后3 d,差异有统计学意义(P＜0.05);观察组术后3、5 d CRP、IL-1、TGF-β1水平均低于对照组,差异有统计学意义(P＜0.05).两组术后1、3、5 d血钙水平均低于术前,差异有统计学意义(P＜0.05);观察组术后1、3、5 d血钙水平均高于对照组,差异有统计学意义(P＜0.05).两组术后3、5 d VAS评分均低于术后1 d(P＜0.05);观察组术后1、3、5 d VAS评分低于对照组,差异有统计学意义(P＜0.05).术前与术后,两组MRC评分、体重指数比较,差异无统计学意义(P＞0.05).观察组总并发症发生率低于对照组,差异有统计学意义(P＜0.05).结论 快速康复策略在继发性甲状旁腺功能亢进患者中有利于控制炎症和降低并发症发生率,对促进早期康复具有重要意义.
Effect of the rapid rehabilitation program in patients with secondary hy-perparathyroidism
Objective To investigate the effect of the rapid rehabilitation program in patients with secondary hyperparathyroidism.Methods A to-tal of 200 patients with secondary hyperparathyroidism who underwent parathyroidectomy in the Third Hospital of Hebei Medical University from January 2020 to June 2023 were selected as the research object,and they were divided into observation group and control group by random number table method,with 100 cases in each group.The observation group was given rapid rehabilitation strategy,the control group was given routine care.The operation time,hospitalization time,postoperative bed time,and hospitalization cost were compared between the two groups.C-reactive protein(CRP),interlenkin-1(IL-1),and transforming growth factor-β1(TGF-β1),blood calcium,visual analogue scale(VAS),medical research council(MRC),body mass index at different time points were compared between the two groups.Results There was no significant difference in operation time between the two groups(P＞0.05).The hospitalization time and postoperative bed time in the observation group were shorter than those in the control group,and the hospitalization cost was lower than that in the control group,the differences were statistically significant(P＜0.05).The levels of CRP,IL-1 and TGF-β1 at 1,3 and 5 days in the two groups after surgery were higher than those before surgery;the levels of CRP,IL-1 and TGF-β,at 3 and 5 days after surgery were lower than those at 1 day after surgery;the levels of CRP,IL-1 and TGF-β1 in the observation group at 1,3 and 5 days after operation were lower than those in the control group,the differences were statistically significant(P＜0.05).The blood calcium levels at 1,3 and 5 days after operation were lower than those before operation,the differences were statistically significant(P＜0.05).The serum calcium levels in the observation group in the two groups were higher than those in the control group at 1,3 and 5 days after operation,the differ-ences were statistically significant(P＜0.05).VAS scores at 3 and 5 days after surgery were lower than those at one day after operation(P＜0.05).The VAS scores of the observation group at 1,3 and 5 days after operation were lower than those of the control group,the differences were statisti-cally significant(P＜0.05).There was no significant difference in MRC score and body mass index between the two groups before and after surgery(P＞0.05).The total complication rate of observation group was lower than that of control group,the differences were statistically significant(P＜0.05).Conclusion Rapid rehabilitation strategy is beneficial to control inflammation and reduce complication rate in patients with secondary hy-perparathyroidism,which is of great significance for promoting early rehabilitation.
NETL
NSTL
万方数据
