摘要
目的探讨腹腔镜直肠癌根治术治疗直肠癌的疗效及对血清CRP、胃肠激素的影响。方法回顾性分析确诊为直肠癌且行直肠癌根治术的患者76例,根据其手术方案的不同分为传统开腹组37例和腹腔镜组39组,分别于术前1天、术后3天、7天检测患者空腹静脉血中CRP、胃泌素、胃动素水平,并比较两组患者术中出血量、住院时间、手术时间及术后并发症发生率的差异。结果术前两组患者的血清CRP及胃肠激素水平比较,差异无无统计学意义(P>0. 05);而术后3天、7天时,腹腔镜组患者血清CRP水平[(23. 45±6. 19) mg/L、(13. 54±2. 98 mg/L)]明显低于传统开腹组的患者[(41. 97±7. 12) mg/L、(19. 16±3. 94) mg/L](P <0. 05),腹腔镜组患者血清中胃动素、胃泌素水平[(332. 17±14. 62) pg/ml、(157. 10±13. 55) pg/ml;(341. 35±11. 05) pg/ml、(151. 12±18. 26) pg/ml]则明显高于传统开腹组的患者[(213. 53±16. 37) pg/ml、(105. 94±12. 89) pg/ml;(206. 07±10. 42) pg/ml、(104. 05±10. 22pg/ml](P <0. 05);而腹腔镜组患者血清中胃动素、胃泌素水平与术前水平比较,差异无统计学意义(P> 0. 05);腹腔镜组患者术中出血量、住院时间、手术时间及术后并发症发生率均优于传统开腹组的(P <0. 05)。结论采用腹腔镜进行直肠癌根治术可减小对患者胃肠激素分泌与机体免疫系统的影响,促进患者康复,减少术中出血风险和术后并发症发生率。
Objective To investigate the curative effect of laparoscopic radical resection of rectal cancer on serum CRP and gastrointestinal hormones. Methods Retrospective analysis of 76 patients with rectal cancer treated with radical surgery were conducted,according to their surgical program,they were divided into the traditional open group with 37 cases,and laparoscopic group with 39 cases.The levels of CRP,gastrin and motilin in the fasting venous blood were measured at 1 day before operation,3 days and 7 days after operation,and the difference in intraoperative blood loss,hospitalization time,operation time and postoperative complication rate were compared between the 2 groups. Results There was no significant difference in serum CRP and gastrointestinal hormones between the 2groups before operation （ P〉0.05）.The levels of serum CRP in laparoscopic group（23.45±6.19 mg/L、13.54±2.98 mg/L） were significantly lower than those of the traditional open group（41.97±7.12 mg/L、19.16±3.94 mg/L） （ P〈0.05） 3 days and 7 days after operation,and the serum levels of motilin and gastrin in patients with laparoscopic group（332.17±14.62 pg/ml、157.10±13.55pg/ml;341.35±11.05 pg/ml、151.12±18.26 pg/ml） were significantly higher than those of the traditional open group（213.53±16.37 pg/ml、105.94±12.89 pg/ml;206.07±10.42 pg/ml、104.05±10.22 pg/ml）（ P〈0.05）.The incidence of intraoperative blood loss,hospitalization time,operation time and postoperative complication were higher in laparoscopic group than in traditional laparotomy group （ P〈0.05）. Conclusion Laparoscopic radical resection of rectal cancer can reduce the effect of gastrointestinal hormone secretion and immune system on the patients,and reduce the risk of intraoperative bleeding and postoperative complications.
作者
张光辉
张进峰
周宏建
ZHANG Guanghui;ZHANG Jinfeng;ZHOU Hongjian.(Zhengzhou Second People＇s Hospital,Zhengzhou,45000)
出处
《实用癌症杂志》
2018年第10期1607-1609,共3页
The Practical Journal of Cancer
关键词
腹腔镜
直肠癌根治术
C-反应蛋白
胃肠激素
Laparoscopy
Radical resection of rectal cancer
C-reactive protein
Gastrointestinal hormones
