摘要
目的探讨低位直肠癌患者采用完全腹腔镜下腹膜外造瘘+盆底腹膜重建腹会阴联合直肠癌根治术(Miles术)治疗的效果。方法方便选取2020年2月—2022年12月在武汉市汉口医院接受治疗的128例低位直肠癌患者,按随机数表法均分为两组,每组64例,对照组实施常规造瘘治疗,观察组实施完全腹腔镜下腹膜外造瘘+盆底腹膜重建Miles术治疗,对两组治疗效果及并发症进行比较。结果观察组患者术后C-反应蛋白、皮质醇、促肾上腺皮质激素水平明显低于对照组,观察组治疗后炎症因子水平低于对照组,自然杀伤细胞、CD4+水平高于对照组,CD8+水平低于对照组,观察组术后1、2、4个月的肛肠功能指标显著优于对照组,差异有统计学意义(P均<0.05);观察组并发症发生率(6.25%)低于对照组(12.50%),差异有统计学意义(χ^(2)=4.783,P<0.05)。结论完全腹腔镜下腹膜外造瘘+盆底腹膜重建Miles术可降低低位直肠癌患者并发症发生率,减轻机体应激及炎症反应,改善患者肛肠动力学指标,对免疫功能影响较小,安全可靠。
Objective To investigate the effect of complete laparoscopic peritoneostomy plus pelvic floor peritoneal reconstruction miles in the treatment of patients with low rectal cancer.Methods A total of one hun⁃dred and twenty-eight patients with low rectal cancer who received treatment in Wuhan Hankou Hospital from February 2020 to December 2022 were conveniently selected and divided into two groups according to random number table method,sixty-four cases each group.The control group was treated with conventional ostomy,and the observation group was treated with complete laparoscopic peritoneostomy plus pelvic floor peritoneal recon⁃struction miles.The therapeutic effect and complications of the two groups were compared.Results The postop⁃erative levels of C-reactive protein,cortisol and adrenocorticotropin in observation group were significantly lower than those in control group,after treatment,the levels of inflammatory factors in the observation group were lower than those in the control group,after treatment,the level of natural killer cells and CD4+in observa⁃tion group were higher than those in control group,and the level of CD8+was lower than that in control group;the anorectal function indexes of the observation group at 1,2 and 4 months after operation were significantly better than those of the control group,and the difference was statistically significant(all P<0.05).The complica⁃tion rate of 6.25%in the observation group was lower than 12.50%in the control group,the difference was sta⁃tistically significant(χ^(2)=4.783,P<0.05).Conclusion The application of complete laparoscopic peritoneostomy plus pelvic floor peritoneal reconstruction miles in patients with low rectal cancer can reduce the incidence of complications,alleviate the body stress and inflammatory response,improve the anorectal kinetic indexes of pa⁃tients,and have little impact on immune function,which is safe and reliable.
作者
杨明
易琨
张征
魏琪
左伟
颜凯
陈园园
YANG Ming;YI Kun;ZHANG Zheng;WEI Qi;ZUO Wei;YAN Kai;CHEN Yuanyuan(Department of Gastrointestinal Hemorrhoids Fistula Surgery,Wuhan Hankou Hospital,Wuhan,Hubei Province,430014 China)
出处
《世界复合医学》
2024年第1期4-8,共5页
World Journal of Complex Medicine
基金
孝感市自然科学计划项目(XGKJ2019010040)。
关键词
腹膜外造瘘
盆底腹膜重建
低位直肠癌
应激水平
炎症因子
Peritoneostomy
Pelvic floor peritoneal reconstruction
Low rectal cancer
Stress level
Inflammatory factor
