摘要
目的探讨两孔法腹腔镜与四孔法腹腔镜手术对中高位直肠癌患者术后恢复及应激反应的影响。方法将2021年4月-2024年4月本院收治的148例中高位直肠癌患者依据手术方式分为两孔腹腔镜组76例和四孔腹腔镜组72例。对比两组的围术期指标、术后恢复情况、手术前后的应激反应,评价两组的并发症情况。结果两孔腹腔镜组的手术时间、术中出血量、切口长度短于四孔腹腔镜组,术后3 d视觉模拟评分(VAS)低于四孔腹腔镜组(P<0.05);两孔腹腔镜组的术后首次下地时间、首次排气、排便时间、首次经口进食时间短于四孔腹腔镜组(P<0.05);术后3 d,两组皮质醇和肾上腺素水平均较术前升高,且两孔腹腔镜组各指标水平低于四孔腹腔镜组(P<0.05);两组术后并发症发生情况比较差异不明显(P>0.05)。结论对中高位直肠癌患者应用两孔法腹腔镜手术相比于四孔法腹腔镜手术优势更明显,术后疼痛轻、恢复快,对应激反应影响较小。
Objective To explore the influence of two-port laparoscopy and four-port laparoscopy on postoperative recovery and stress response in patients with middle and upper rectal cancer.Methods 148 patients with middle and upper rectal cancer in the hospital from April 2021 to April 2024 were divided into two-port laparoscopy group(n=76,two-port laparoscopic surgery)and four-port laparoscopy group(n=72,four-port laparoscopic surgery)according to the surgical method.The perioperative indexes,postoperative recovery status,stress response before and after surgery were compared between the two groups,and the complications in both groups were evaluated.Results The surgial time,intraoperative blood loss,The incision length in the two-port laparoscopy group was shorter,and the visual analogue scale(VAS)score at 3 days after surgery was lower than that in the four-port laparoscopy group(P<0.05).The first postoperative ambulation time,first exhaust time,first defecation time and first oral feeding time were shorter in the two-port laparoscopy group than those in the four-port laparoscopy group(P<0.05).At 3 days after surgery,the levels of cortisol and epinephrine were enhanced in both groups than those before surgery,and the above levels in the two-port laparoscopy group were lower compared to the four-port laparoscopy group(P<0.05).No obvious differences were manifested between both groups in terms of postoperative complications(P>0.05).Conclusion Compared with four-port laparoscopic surgery,two-port laparoscopic surgery has more obvious advantages in patients with middle and upper rectal cancer,and the latter one has milder postoperative pain,faster recovery and smaller impact on stress response.
作者
宋志岗
连彦军
李颖
董华兴
刘帅
SONG Zhigang;LIAN Yanjun;LI Ying;DONG Huaxing;LIU Shuai(Department of Gastrointestinal Surgery,The Third Hospital of Xingtai,Xingtai 054000,Hebei,China;Emergency Department,The Third Hospital of Xingtai,Xingtai 054000,Hebei,China)
出处
《西部医学》
2026年第1期138-141,共4页
Medical Journal of West China
基金
邢台市重点研发计划自筹项目(2023ZC101)。
关键词
中高位直肠癌
两孔法腹腔镜手术
四孔法腹腔镜手术
术后恢复
应激反应
并发症
Middle and upper rectal cancer
Two-port laparoscopic surgery
Four-port laparoscopic surgery
Postoperative recovery
Stress response
Complications
