摘要
目的研究腹腔镜结直肠癌根治术的临床价值。方法选择2012年5月至2015年3月乐山市市中区人民医院收治的结直肠癌患者80例为研究对象,采用随机数字表法分为腹腔镜组和开腹组,各40例。腹腔镜组进行腹腔镜下结直肠癌根治术,开腹组进行常规开腹结直肠癌根治术。比较两组患者的手术情况、炎症应激反应、胃肠功能、术后存活和复发情况。结果腹腔镜组患者手术时间、术中出血量、术后切口引流量、术后卧床时间等均明显低于对照组[(79±9)min比(121±16)min、(37±4)m L比(78±9)m L、(24±4)m L比(51±7)m L、(2.6±0.7)d比(4.1±0.6)d],差异有统计学意义(P<0.01)。腹腔镜组术后肿瘤坏死因子α、C反应蛋白、白细胞介素6、去甲肾上腺素、皮质醇均低于开腹组[(45±5)mg/L比(59±6)mg/L,(34.9±4.6)mg/L比(66.4±7.3)mg/L,(81±8)μg/L比(103±11)μg/L,(321±26)μg/L比(362±35)μg/L,(145±18)μg/L比(232±34)μg/L],差异有统计学意义(P<0.01)。腹腔镜组术后腹胀持续时间、肛门排气时间短于开腹组[(3.3±0.5)d比(4.9±0.7)d,(3.0±0.5)d比(4.1±0.5)d],胃动素、胃泌素高于开腹组[(225±28)ng/L比(168±21)ng/L,(118±12)ng/L比(88±10)ng/L],差异有统计学意义(P<0.01)。术后3年,腹腔镜组病死率和复发率低于开腹组(P<0.05)。结论腹腔镜下结直肠癌根治术有助于减小手术创伤,缓解炎症与应激反应,保护胃肠功能,促进术后恢复,改善预后情况。
Objective To study the clinical effect of laparoscopic radical resection of colorectal cancer.Methods Total of 80 patients with colorectal cancer in Leshan Downtown District People＇ s Hospital from May 2012 to Mar. 2015 were enrolled and divided into laparoscopic group and open group according to the random number table method,40 cases each. Laparoscopic group received laparoscopic resection of colorectal cancer,while the open group received conventional open laparotomy resection of colorectal cancer. Then surgery condition,inflammation and stress response,gastrointestinal function,postoperative survival and relapse of the two groups were compared. Results The surgery time,blood loss,postoperative wound drainage,bed time of the laparoscopic group were significantly lower than the open group [（ 79 ± 9） min vs（ 121 ±16） min,（ 37 ± 4） m L vs（ 78 ± 9） m L,（ 24 ± 4） m L vs（ 51 ± 7） m L,（ 2. 6 ± 0. 7） d vs（ 4. 1 ± 0. 6） d]（ P〈 0. 01）; TNF-α,CRP,IL-6,NE,Cor of the laparoscopic group were significantly lower than open group[（ 45 ± 5） mg/L vs（ 59 ± 6） mg/L,（ 34. 9 ± 4. 6） mg/L vs（ 66. 4 ± 7. 3） mg/L,（ 81 ± 8） μg/L vs（ 103 ± 11） μg/L,（ 321 ± 26） μg/L vs（ 362 ± 35） μg/L,（ 145 ± 18） μg/L vs（ 232 ± 34） μg/L]（ P〈 0. 01）; gastric bowel function： duration of abdominal distension,anal exhaust time of the laparoscopic group were significantly lower than the open group[（ 3. 3 ± 0. 5） d vs（ 4. 9 ± 0. 7） d,（ 3. 0 ± 0. 5） d vs（ 4. 1 ±0. 5） d],motilin and gastrin of the laparoscopic group were significantly higher than the open group[（ 225 ±28） ng / L vs（ 168 ± 21） ng / L,（ 118 ± 12） ng / L vs（ 88 ± 10） ng / L]（ P〈 0. 01）; 3-year mortality rate,and the relapse rate of the laparoscopic group were significantly lower than open group（ P〈 0. 05）.Conclusion Laparoscopic colorectal cancer resection is helpful to reduce the surgical trauma,reduce inflammation and stress response,protect the gastrointestinal function,promote postoperative recovery and improve the prognosis.
出处
《医学综述》
2016年第8期1572-1575,共4页
Medical Recapitulate
基金
乐山市市中区科技计划项目(12SCG23)
关键词
结直肠癌
腹腔镜
预后
炎症应激反应
胃肠功能
Colorectal cancer
Laparoscopy
Prognosis
Inflammatory stress response
Gastrointestinal function
