Effect of fast track surgery on anxiety index and stress indices in patients undergoing laparoscopic cholecystectomy

Objective To investigate the effect of fast track surgery( FTS) on anxiety index and stress indices in patients undergoing laparoscopic cholecystectomy.Methods The patients who were hospitalized in Department of General Surgery,The Second People's Hospital of Lanzhou,from March 2015 to July 2016 and underwent laparoscopic cholecystectomy were enrolled and randomly divided into FTS group and conventional treatment group,with 200 patients in each group.The patients in the FTS group were given FTS in the perioperative period,and those in the conventional treatment group were given conventional treatment.The C- reactive protein( CRP) level,white blood cell count( WBC),and interleukin- 6( IL- 6) level were measured on admission,at 1 hour before surgery,and at 24 and 48 hours after surgery,as well as the anxiety index in Hamilton anxiety scale( HAMA).The t- test was used for comparison of continuous data between groups,and the chi- square test was used for comparison of categorical data between groups.Results There was no significant difference in anxiety index between the FTS group and the conventional treatment group on admission( P > 0.05);at 1 hour before surgery and at 24 and48 hours after surgery,there were significant differences in anxiety index between the two groups( χ~2= 12.73,13.17,and 14.12,all P <0.05).On admission and at 1 hour before surgery,there were no significant differences in the CRP level,WBC,and IL- 6 level between the FTS group and the conventional treatment group( all P > 0.05);at 24 and 48 hours after surgery,there were significant differences in the CRP level,WBC,and IL- 6 level between the two groups [CRP24h:8.47 ± 0.78 mg/L vs 17.56 ± 1.31 mg/L,t = 17.63,P < 0.05;WBC24h:( 8.3 ±3.4) ×10~9/ L vs( 10.2 ± 3.8) × 10~9/ L,t = 21.62,P < 0.05;IL- 624h:127.43 ±37.46 ng/L vs 146.25 ±42.56 ng/L,t =26.32,P < 0.05;CRP48h:( 6.57 ±1.27) mg/L vs( 10.76 ±1.25) mg/L,t =19.25,P <0.05;WBC48h:( 7.1 ±2.3) ×10~9/ L vs( 9.3 ±2.4) ×109/ L,t = 23.34,P< 0.05;IL- 648h:( 103.27 ± 38.54) ng/L vs( 127.76 ± 38.65) ng/L,t = 25.24,P < 0.05].There was a significant difference in the length of hospital stay between the FTS group and the conventional treatment group( 4 ± 1 d vs 7 ± 2 d,t = 13.15,P < 0.05),and there was also a significant difference in hospital costs( 7800 ± 500 yuan vs 9200 ± 600 yuan,t = 10.61,P < 0.05).Conclusion In patients undergoing laparoscopic cholecystectomy,FTS helps to reduce anxious emotion and stress response,shorten the length of hospital stay,and promote their rehabilitation.