Effect of rapid rehabilitation nursing on inflammation and liver function after laparoscopic radical resection of primary liver cancer

Abstract

Objective: To explore the effect of rapid rehabilitation nursing on inflammation and liver function in patients with primary liver cancer (PLC) after laparoscopic radical resection.

Methods: A total of 124 PLC patients who underwent laparoscopic radical surgery in the Zhuji People's Hospital of Zhejiang Province from April 2019 to July 2021 were enrolled in this retrospective study. Among them, 65 patients who received rapid rehabilitation nursing were assigned into the observation group (OG), and the other 59 with routine nursing were considered to be the control group (CG). The pain before operation (T0), 3 days after operation (T1) and 7 days after operation (T2) was evaluated by visual analogue scale (VAS). The perioperative related indexes and nursing satisfaction were compared. The levels of liver function indexes alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL) and inflammatory factors C-reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were measured before operation, 1 day and 7 days after operation. Finally, the incidence of postoperative complications was counted, the 6-month survival rate of both groups of patients was compared.

Results: There was no obvious difference in VAS scores between the two groups at T0 (P>0.050), but the VAS scores at T1 and T2 in the OG were lower than those in the CG (P<0.001). There was no marked difference in the total operation time. Compared with the CG, the time to first exhaust, catheter indwelling and hospitalization in the OG were shorter (P<0.001) and the nursing satisfaction rate was higher (P<0.05). There was no obvious difference in ALT, AST and TBIL on the 1st day after operation (P>0.05); however, on the 7th day after operation, ALT and AST were lower while TBIL was higher in the OG (all P<0.05). There was no marked difference in CRP, IL-6 and TNF-α between the two groups on postoperative day 1 (P>0.05), but the levels were lower in the OG than those in the CG on postoperative day 7 (all P<0.05), and the total incidence of adverse reactions in the OG was lower (P<0.05). There was no statistical difference in the postoperative survival rate between both groups of patients (P>0.05). Age, number of lesions, tumor size, Child-Pugh grade, AST, TBIL, CRP, IL-6, TNF-α were associated with the survival rate of patients.

Conclusion: Rapid rehabilitation nursing can effectively reduce adverse reactions after laparoscopic radical resection of PLC. Thus, it has a high application value in future clinical treatment.

Keywords: Laparoscopic radical resection of primary liver cancer; inflammation; liver function; rapid rehabilitation nursing.

Figure 1

Influence of different nursing methods on patients during perioperative period. A. There was no marked difference in the total operation time between the two groups (P>0.05). B. The first exhaust time of the observation group (OG) was earlier than that of the control group (CG) (P<0.05). C. The indwelling time of catheter in the OG was less than that in the CG (P<0.05). D. The time of hospitalization in the OG was less than that in the CG (P<0.05). Note: **, P<0.01; ***, P<0.001.

Figure 2

Effect of different nursing methods on patients’ liver function. A. The ALT of both groups on the 1st day after operation was higher than that before operation (P<0.05), but there is no marked difference between groups (P<0.05). On the 7th day after operation, the ALT was lower than that on the 1st day after operation, and the ALT in the OG was lower than that in the CG (P<0.05). B. The AST of both groups on the 1st day after operation was higher than that before operation (P<0.05), but there was no marked difference between groups (P<0.05). On the 7th day after operation, the AST of both groups was lower than that on the 1st day after operation, and the AST in the OG was lower than that in the CG (P<0.05). C. The TBIL of both groups on the 1st day after operation was lower than that before operation (P<0.05), but there was no marked difference between groups (P<0.05). On the 7th day after operation, the TBIL of both groups was higher than that on the 1st day after operation, and the TBIL in the OG was higher than that in the CG (P<0.05).

Figure 3

Effect of different nursing methods on the inflammation of patients. A-C. The levels of inflammatory factors CRP, IL-6 and TNF-α increased after operation (P<0.05). Rapid rehabilitation nursing reduced the level of inflammation more quickly, and the level in the OG was lower than that in the CG 7 days after operation (P<0.05). Note: A, compared with day 1 (P<0.05), B, compared with day 7 (P<0.05), and C, compared with the observation group (P<0.05).

Figure 4

Comparison of survival rate between the two groups. There was no significant difference in the 6-month survival rate between the two groups (P=0.536).