摘要
目的探讨腹腔镜手术与开腹手术方法对直肠癌术后机体能量代谢的影响。方法病例为2010年5月至2012年5月医院择期直肠癌手术患者87例,根据手术方法分为腹腔镜组(47例)和开腹组(40例),记录两组手术及术后恢复情况,检测术前及术后1 d、3 d静息能量消耗情况;测定术前及术后3 d、9 d炎性因子变化;记录2组术后并发症发生率;电话或门诊随访3年,记录1年、3年生存率。结果腹腔镜组手术时间及术后恢复时间短于开腹组,术中出血量低于开腹组,具有统计学意义(P<0.05);腹腔镜组术后1 d、3 d静息能量消耗显著低于开腹组,具有统计学意义(P<0.05);腹腔镜组术后3 d、9 d C反应蛋白(CRP)、肿瘤坏死因子(TNF-α)、白介素-6(IL-6)水平均显著低于开腹组,具有统计学意义(P<0.05);腹腔镜组术后切口感染发生率为4.26%显著低于开腹组20.0%,具有统计学意义(P<0.05);两组术后1年、3年生存率对比无显著差异,不具统计学意义(P>0.05)。结论腹腔镜手术对直肠癌患者静息能量消耗影响小,有利于缩短术后恢复时间,但远期疗效与开腹手术无差异。
Objective To investigate the effects of different surgical methods on body energy metabolism after rectal cancer surgery. Methods 87 cases of patients with rectal cancer undergoing elective surgery in the hospital from May 2010 to May 2012 were divided into the laparoscopic group（47 cases） and the open group（40 cases）according to the surgical methods. Surgery and postoperative recovery in the 2 groups were recorded. Resting energy expenditure before surgery and in 1d and 3d after surgery was detected. The changes of inflammatory factors before surgery and in 3d and 9d after surgery were determined; The incidence rates of postoperative complications in the 2 groups were recorded; 3 years of telephone or outpatient follow-up later, 1-year and 3-year survival rates were recorded. Results The operation time and postoperative recovery time of the laparoscopic group was shorter than that of the open group and intraoperative blood loss was lower than that of the open group（P 〈0.05）;1d and 3d after surgery, the resting energy expenditure of the laparoscopic group was significantly lower than that of the open group（P 〈0.05）; 3d and 9d after surgery, the levels of C reactive protein（CRP）, tumor necrosis factor alpha（TNF-alpha） and interleukin-6（IL-6） in the laparoscopic group were significantly lower than those in the open group（P 〈0.05）; The incidence of incision infection in the laparoscopic group（4.26%） was significantly lower than that in the open group（20.0%）（P 〈0.05）; After surgery, there were no significant differences in 1-year and 3-year survival rates between the 2 groups（P 〉0.05）. Conclusion Laparoscopic surgery has little effect on the resting energy expenditure of patients with rectal cancer and it is beneficial to shorten the recovery time after surgery but there is no difference in long-term curative effect, compared with open surgery.
出处
《结直肠肛门外科》
2015年第5期343-347,共5页
Journal of Colorectal & Anal Surgery
关键词
腹腔镜手术
炎性因子
静息能量消耗
远期效果
切口感染
Laparoscopic surgery
Inflammatory factor
Resting energy expenditure
Long-term effect
Incision infection
