摘要
目的:探讨单孔腹腔镜直肠癌根治术的临床疗效及对患者血清血红素氧化酶(HO)-1、癌胚抗原(CEA)、人类软骨糖蛋白39(YKL-40)、可溶性白介素-2受体(s IL-2R)的影响。方法:选择2013年1月至2015年1月我院接诊的92例直肠癌患者,通过随机数表法分为观察组(n=46)和对照组(n=46),对照组使用传统多孔腹腔镜直肠癌根治术,观察组使用单孔腹腔镜直肠癌根治术。比较两组围术期情况及术后并发症的发生情况,手术前24 h、手术后24 h血清HO-1、CEA、YKL-40、s IL-2R水平的变化,并随访2年,比较两组的生存率。结果:两组手术时间、淋巴结切除个数比较差异无统计学意义(P>0.05),观察组术中出血量显著少于对照组,术后排气时间、住院时间明显短于对照组(P<0.05)。手术后24 h,两组血清HO-1、YKL-40、s IL-2R水平均较手术前显著升高(P<0.05),血清CEA水平较手术前明显降低(P<0.05),且观察组血清HO-1、YKL-40、s IL-2R水平均明显低于对照组(P<0.05),两组手术后血清CEA水平比较差异无统计学意义(P>0.05);观察组吻合口瘘、尿潴留、切口感染、肺部感染总发生率明显低于对照组(P<0.05),两组术后2年生存率比较差异无统计学意义(P>0.05)。结论:采用单孔腹腔镜直肠癌根治术治疗直肠癌患者的临床效果明显优于传统多孔腹腔镜直肠癌根治术,且安全性更高,患者术后恢复更快,可能与其有效降低患者血清HO-1、YKL-40、s IL-2R、CEA水平有关。
Objective： To study the clinical efficacy of single-port laparoscopic radical resection in the treatment of rectal cancer and its effect on the serum heme oxygenase（HO）-1, carcinoembryonic antigen（CEA）, chitinase-3-like protein 1（YKL-40） and soluble interleukin-2 receptor（s IL-2 R） levels. Methods： 92 patients of rectal cancer who were treated from January 2013 to January 2015 in our hospital were selected. According to random number table, those patients were divided into the observation group（n=46） and the control group（n=46）. The control group was treated with traditional porous laparoscopic radical resection of rectal cancer, while the observation group was treated with single-port laparoscopic radical resection of rectal cancer. The perioperative period and postoperative complications were compared between the two groups, the fasting venous blood was taken at 24 h before operation and at 24 h after operation, the expressions of serum HO-1, CEA, YKL-40 and s IL-2 R were detected, the survival rate was recorded after 2 years of follow-up. Results：The operation time and the number of resected lymph nodes showed no significant difference between the two groups（P〉 0.05）, the amount of bleeding in the observation group was significantly less than that of the control group, the postoperative exhaust time and hospitalization stay of observation group were significantly shorter than those of the control group（P〈 0.05）; at 24 h after operation, the serum HO-1, YKL-40 and s IL-2 R levels in both groups were significantly higher than those before operation, and the serum CEA level was significantly lower than that before operation（P〈0.05）, the serum HO-1, YKL-40 and s IL-2 R leves in the observation group were significantly lower than those of the control group（P 〈0.05）, there was no significant difference in the serum CEA between the two groups（P 〉0.05）; the total incidence of anastomotic leakage, retention of urine, incision infection and pulmonary infection
作者
韩新峰
袁增江
秦瑞锋
刘福生
张美莲
HAN Xin-feng; YUAN Zeng-jian; QIN Rui-feng; LIU Fu-sheng; ZHANG Mei-lian(General surgery department, Handan Central Hospital, Handan, Hebei, 056001, China; Department of Radiology, Handan Central Hospital, Handan, Hebei, 056001, China; 3 Affiliated Hospital of Hebei University of Engineering, Handan, Hebei, 056002, China)
出处
《现代生物医学进展》
CAS
2018年第17期3344-3347,共4页
Progress in Modern Biomedicine
基金
河北省自然科学基金项目(201403130)
关键词
直肠癌根治术
单孔腹腔镜
血红素氧化酶-1
癌胚抗原
人类软骨糖蛋白39
可溶性白介素-2受体
Radical resection of rectal cancer
Single-port laparoscope
Heme oxygenase-1
Carcinoembryonic antigen
Chitinase- 3 -like protein 1
Soluble interleukin-2 receptor
