摘要
目的分析腹腔镜直肠癌根治术患者围术期炎性状态及机体代谢的变化情况。方法选取2013年1月—2014年10月进行腹腔镜直肠癌根治术治疗的40例患者为观察组,并以同时期采用开腹直肠癌根治术治疗的40例患者为对照组。比较2组患者术前1 d与术后3、7、14 d的血清炎性指标[降钙素原(PCT)、超敏C反应蛋白(hsCRP)、白介素6(IL-6)及肿瘤坏死因子α(TNF-α)]、蛋白代谢指标[前白蛋白(PA)、白蛋白(Alb)、视黄醇结合蛋白(RBP)及转铁蛋白(TRE)]、糖代谢指标[胰岛素(INS)、C肽(CP)及胰高血糖素(G1u)]。结果 2组患者手术前1 d血清炎性指标、蛋白代谢指标及糖代谢指标比较差异均无统计学意义(P均>0.05)。与对照组比较,观察组手术后3、7 d及14 d的血清炎性指标均较低(P均<0.05),且2组内术后不同时间点PCT、hs-CRP、IL-6、TNF-α比较差异亦具有统计学意义(F=6.119、7.089、6.789、7.765,P均<0.05)。观察组术后3、7 d及14 d的蛋白代谢指标均高于对照组,糖代谢指标水平均低于对照组(P均<0.05),且2组内术后不同时间点PA、Alb、RBP、TRE及INS、CP、Glu比较差异亦具有统计学意义(F=6.237、7.115、6.546、8.456,6.895、7.258、7.546,P均<0.05)。结论腹腔镜直肠癌根治术患者围术期炎性状态及机体代谢的变化较大,对于患者术后机体不良状态的控制有着积极的临床意义。
Objective To analyze the perioperative inflammatory state changes and metabolism of laparoscopic radical resection of rectal carcinoma.Methods From January 2013 to October 2014,40 cases of rectal cancer treated with laparoscopic radical resection were enrolled as the observation group and 40 cases with open radical resection of rectal cancer in the same period were enrolled as control group.Preoperative and postoperative 1,3,7,14 d serum inflammatory markers of procalcitoniri（PCT）,high sensitive C reactive protein（hs-CRP） and interleukin-6（IL-6） and tumor necrosis factor alpha（TNF-α） and protein metabolism including prealbumin（PA）,albumin（Alb）,retinol binding protein（RBP） and transferrin（TRE）,indexes of glucose metabolism,insulin（INS） and C peptide（CP） and glucagon（Glu） were compared between the2 groups.Results 1 d before surgery,serum inflammatory markers,protein metabolism and glucose metabolic indexes in the2 groups were not significant different（P〉0.05）.Compared with the control group,the observation group after operation 3,7 and 14 d＇s serum inflammatory markers were more lower（P〈0.05）,and at different time points after surgery,PCT,hsCRP,IL-6,TNF-a within the 2 groups also showed significant differences（F =6.119,F =7.089,F =6.789,F =7.765,P〈0.05）.The protein metabolism indexes in the observation group at 3,7,14 d were higher than those of the control group,glucose metabolism indexes were lower than those of control group（P〈0.05）,and at different time points after surgery,PA,Alb,RBP,TRE and INS,CP,Glu within the groups also showed significant differences（F = 6.237,F =7.115,F =6.546,F =8.456,F =6.895,F =7.258,F =7.546,P〈0.05）.Conclusion Perioperative inflammatory slate and metabolism after laparoscopic colorectal cancer radical resection showed obvious changes,it revealed positive significance for control of postoperative body adverse state.
出处
《疑难病杂志》
CAS
2015年第4期366-368,共3页
Chinese Journal of Difficult and Complicated Cases
关键词
腹腔镜直肠癌根治术
围术期
炎性状态
蛋白代谢
糖代谢
Laparoscopic radical resection of rectal cancer
Perioperative period
Inflammatory state
Protein metabolism
Glucose metabolism
