摘要
目的探究腹腔镜手术治疗80岁以上老年结直肠癌患者的效果。方法选取本院2017年1月至2020年1月收治的结直肠癌患者100例作为研究对象,按照手术治疗方式不同分为开腹组(n=56)与腹腔镜组(n=44)。开腹组给予开腹直肠癌切除手术治疗,腹腔镜组给予腹腔镜直肠癌切除手术治疗,比较两组围术期指标、手术前后血清炎性因子水平、胃肠功能指标及并发症发生率。结果腹腔镜组手术时间长于开腹组,术中出血量少于开腹组,术中输血率低于开腹组,切口长度、下床活动时间、住院时间短于开腹组,差异均有统计学意义(P<0.05)。两组清扫淋巴总数比较差异无统计学意义。术前,两组血清TNF-α、IL-1β及IL-6水平比较差异无统计学意义;术后,两组血清TNF-α、IL-1β及IL-6水平均低于术前,且腹腔镜组低于开腹组,差异有统计学意义(P<0.05)。腹腔镜组腹胀持续时间、肠鸣音恢复时间、肛门排气时间均短于开腹组,差异有统计学意义(P<0.05)。两组术后并发症发生率比较差异无统计学意义。结论腹腔镜直肠癌切除手术治疗80岁以上老年结直肠癌对患者创伤较小,可降低TNF-α、IL-1β及IL-6水平,术后胃肠功能恢复情况较好,未增加并发症发生率,具有较高的安全性。
Objective To explore the effect of laparoscopic surgery on the treatment of elderly patients with colorectal cancer over 80 years old.Methods 100 patients with colorectal cancer admitted to our hospital from January 2017 to January 2020 were selected as the research subjects. According to different surgical treatment methods, they were divided into laparotomy group(n=56) and laparoscopic group(n=44). The laparotomy group was treated with laparotomy rectal cancer resection, and the laparoscopic group was treated with laparoscopic rectal cancer resection. The perioperative indexes, serum inflammatory factor levels before and after operation, gastrointestinal function indexes and complication rates between the two groups were compared. Results The operation time of the laparoscopic group was longer than that of the laparotomy group, the blood loss during the operation was less than that of the laparotomy group, the intraoperative blood transfusion rate was lower than that of the laparotomy group,the length of incision, the time of getting out of bed, and the hospital stay were shorter than those of the laparotomy group, the difference was statistically significant(P<0.05). There was no statistically significant difference in the total number of lymph nodes dissected between the two groups. Before operation, there was no significant difference in the levels of serum TNF-α, IL-1β and IL-6 between the two groups. After operation, the levels of serum TNF-α, IL-1β and IL-6 in the two groups were lower than those before operation, the laparoscopic group were lower than the open group, the difference was statistically significant(P<0.05). The duration of abdominal distension, the recovery time of bowel sounds, and the time of anal exhaust in the laparoscopic group were shorter than those in the laparotomy group, and the difference was statistically significant(P<0.05). There was no statistically significant difference in the incidence of postoperative complications between the two groups. Conclusion Laparoscopic rectal
作者
王学信
孟庆国
常绪祥
WANG Xuexin;MENG Qingguo;CHANG Xuxiang(Department of General Surgery,Dongping County People's Hospital,Tai'an,Shangdong,271500,China)
出处
《当代医学》
2021年第34期27-30,共4页
Contemporary Medicine
关键词
开腹手术
腹腔镜手术
结直肠癌
围术期指标
胃肠功能
并发症
Laparotomy
Laparoscopic surgery
Colorectal cancer
Perioperative index
Gastrointestinal function
complications
