分析腹腔镜联合支架手术在结肠癌并肠梗阻患者中的应用及研究  

Application of laparoscopic combined with stenting in colon cancer patients combined with postoperative intestinal obstruction

作　　者：崔永欣[1] 连加玉[2] CUI Yongxin;LIAN Jiayu(Department of General Surgery,Zhoukou Central Hospital,Zhoukou,466000,Henan,China)

机构地区：[1]周口市中心医院普外(肛肠外科),河南周口466000 [2]周口市中心医院普外科,河南周口466000

出　　处：《新疆医学》2022年第12期1419-1422,共4页Xinjiang Medical Journal

摘　　要：目的探讨腹腔镜联合支架手术对结肠癌并肠梗阻患者治疗效果及预后的影响。方法选择2017年5月-2020年5月周口市中心医院结肠癌并肠梗阻患者84例作为对象,随机分为对照组(n=42例)和观察组(n=42例)。对照组采用开腹手术治疗干预,观察组先行支架手术治疗,术后择期(7-14 d)给予腹腔镜手术干预,两组术后7d对患者效果进行评估,比较两组手术指标、SRC-3基因水平、炎症因子水平、术后并发症发生率。结果观察组围术期手术时间较对照组长(P<0.05);观察组围术期出血量、切口长度、术后排气、住院时间多(短)于对照组(P<0.05);两组术后7d SRC-3 m RNA水平无统计学意义(P>0.05);观察组术后7d炎症因子水平低于对照组(P<0.05);观察组术后切口感染、腹腔出血、肺部感染、吻合口漏、炎性肠梗阻发生率,低于对照组(P<0.05)。结论先行支架手术治疗,术后给予腹腔镜手术干预治疗结肠癌并肠梗阻患者中手术创伤较小,能降低IL-6、TNF-α、IL-10等炎症因子水平,手术安全性较高,预后较好。Objective To investigate the treatmenteffect and prognosis of laparoscopic combined stent surgery in colon cancer patients with intestinal obstruction.Methods A total of 84 patients with colon cancer complicated with intestinal obstruction in Zhoukou Central Hospital from May 2017 to May 2020 were selected and randomly divided into control group(n=42)and observation group(n=42).The control group was treated with open surgery,the observation group was treated with stent surgery first,and laparoscopic surgery was given at an elective time(7-14 days)after operation.The effects of the two groups were evaluated at 7 days after operation,and the surgical indicators,SRC-3 gene level,inflammatory factors level,and postoperative complication rate were compared between the two groups.Results The perioperative operation time of observation group was longer than that of control group(P<0.05).The perioperative blood loss,incision length,postoperative exhaust and hospital stay in the observation group were more(shorter)than those in the control group(P<0.05).There was no significant difference in SRC-3 m RNA level at 7 days after operation between the two groups(P>0.05).The level of inflammatory factors in the observation group was lower than that in the control group 7 days after operation(P<0.05).The incidence of incision infection,abdominal hemorrhage,lung infection,anastomotic leakage and inflammatory intestinal obstruction in the observation group were lower than those in the control group(P<0.05).Conclusions In patients with colon cancer complicated with intestinal obstruction treated with stent surgery first and laparoscopic surgery after operation,the surgical trauma is less,and the levels of IL-6,TNF-α,IL-10 and other inflammatory factors can be reduced.The surgical safety is high and the prognosis is good.

关 键 词：腹腔镜 支架手术 结肠癌 术后肠梗阻 手术创伤 炎症因子 甾体类受体共激活因子3基因 

分 类 号：R735.35[医药卫生—肿瘤]