摘要
目的比较腹腔镜与开腹结直肠癌根治术对机体微炎症和氧化应激的影响。方法选择有结直肠癌根治术指征的30例患者分为两组:腹腔镜结直肠癌根治术15例(LCR组),开腹结直肠癌根治术15例(OCR组)。所有患者均分别于手术前、术后第1d、3d、和5d抽取静脉血,测定血清C反应蛋白(CRP)、IL-6和肿瘤坏死因子-α(TNF-α),测定血浆丙二醛(MDA)、超氧化物歧化酶(SOD)。结果LCR组术后1d时CRP、IL-6、TNF-α水平均明显高于术前,术后3d时均明显下降,术后5d时IL-6、TNF-α已降至术前水平;OCR组术后1d时CRP、IL-6、TNF-α水平也明显高于术前,术后3d时IL-6、TNF-α有所下降,至术后5d时仍未降至术前水平,CRP则持续升高至术后3d达高峰后,术后5d时才有所下降;OCR组术后1d、3d、5d时CRP、IL-6、TNF-α水平均明显高于LCR组。LCR组术后1d时MDA、SOD水平与术前差异显著,术后3d、5d时已经接近术前水平;OCR组术后1d、3d时MDA、SOD均与术前差异显著,5d时已接近术前水平;术后1d、3d时OCR组MDA均高于LCR组,而SOD均低于LCR组。结论LCR手术创伤小,术后微炎症反应轻,机体氧化应激反应较OCR低,且恢复迅速,两种手术术后氧化应激反应均炎症反应更早恢复正常。
Objective To compare the impacts of laparoscopic and open radical resection of colorectal cancer on inflammation and oxidative stress. Methods Thirty patients with colorectal cancer were divided into 2 groups： 15 cases were treated with laparoscopic colorectal cancer resection（LCR group） and 15 cases were treated with open colorectal cancer resection（OCR group）. Venous blood was drawn before operation and the 1st day, 3rd day and 5th day after operation. CRP, IL6, TNF-α, MDA, SOD were measured. Results Serum levels of CRP, IL6, TNF-α were significantly increased on the 1st day and decreased on the 3rd day after operation in LCR group. On the 5th day after operation, IL-6, TNF-α restored to normal level. CRP, IL6, TNF-α were also significantly increased on the 1st day after operation in OCR group. IL-6, TNF-α were decreased on the 3rd day, but they did not restore to normal on the 5th day. CRP kept on increasing till the 3rd day and was decreased on the 5th day. CRP, IL6, TNF-α in OCR group were obviously higher than that in LCR group after operation. MDA, SOD in LCR group showed significant difference between preoperation and 1st day after operation. On the 3rd and 5th day, both MDA and SOD restored to normal. In the OCR group, MDA was significantly increased and SOD was significantly decreased on the 1st day, 3rd day after operation, and both restored to normal on the 5th day after operation. MDA in OCR group was significantly higher than that in LCR group on the 1st and 3rd day after operation, while SOD in OCR group was significantly lower than that in LCR group in the same period. Conclusions LCR causes less trauma and less influence on inflammation and oxidative stress as compared with OCR.
出处
《现代消化及介入诊疗》
2009年第3期141-144,共4页
Modern Interventional Diagnosis and Treatment in Gastroenterology
关键词
腹腔镜
结直肠癌根治术
炎症
氧化应激
Laparoscopy
Colorectal cancer resection
Inflammation
Oxidative stress
