摘要
目的了解高龄病人腹腔镜与开腹结直肠癌根治术围手术期血清内脏蛋白的差异。方法选择行腹腔镜手术高龄结直肠癌病人(腹腔镜组)20例,行开腹结直肠癌根治术高龄病人(开腹组)21例,于术前、术后第1天、术后第2天、术后第3天晨采血,检测血清清蛋白(ALB)、前清蛋白(PRE)、转铁蛋白(TRF)、视黄醇结合蛋白(RbP)水平。结果腹腔镜组手术时间、术中出血量和术后排气时间明显少于开腹组(t=2.268～6.615,P<0.05),两组术前ALB、PRE、TRF、RbP水平差异无显著性(P>0.05)。术后第1、2、3天腹腔镜组与开腹组4种蛋白水平均较术前明显下降,差异有显著性(F=30.35～126.30,q=7.85～20.14,P<0.01);腹腔镜组及开腹组术后1～3d组内4种蛋白水平比较,差异无显著性(P>0.05)。术后第1、2天两组之间4种蛋白水平比较,差异无显著性(P>0.05);术后第3天腹腔镜组4种蛋白水平均明显高于开腹组(t=6.55～11.16,P<0.01)。结论高龄病人腹腔镜结直肠癌根治术较开腹手术创伤小,有利于人体内脏蛋白的恢复。
Objective To investigate the difference of perioperative visceral protein between aged patients undergoing laparoscopically-assisted resection （LAR） of coloreetal carcinoma and open surgery. Methods Twenty patients undergoing LAR for colorectal cancer （group Ⅰ） and 21 undergoing open surgery （group 2） were enrolled in this study. Visceral proteins, including albumin （ALB）, prealbumin （PRE）, transferrin （TRF） and retinal-binding protein （RbP）, were assayed preoperatively and on clays 1, 2, and 3 after surgery. Results The operation time was shorter, blood loss was less and postoperative venting was quicker in group 1 than those in group 2 （t=2. 268-6. 615,P〈0.05）. The differences of preoperative levels of ALB, PRE, TRF and RbP between the two groups were not significant （P〉0.05）. The levels of the four kinds of protein decreased significantly in both groups on days 1, 2 and 3 after surgery compared with pre operation （F=30.35-126.30,q=7.85-20.14,P〈0.01）. The levels of all the proteins detected between the two groups within three days and two days were not significantly different （P〉0.05）. The levels of the four proteins in group 1 were significantly higher than those in group 2 on day 4 postoperatively （t= 6.55-11. 16, P〈 0.01）. Conclusion LAR of colorectal carcinoma is less traumatic compared with open surgery in the aged and conduces to the restoration of visceral proteins and nutrition status.
出处
《齐鲁医学杂志》
2009年第2期106-108,共3页
Medical Journal of Qilu
