腹腔镜直肠癌Miles手术对机体应激反应和内脏蛋白的影响  

The influence of laparoscopic Miles surgery for rectal carcinoma on stress response and visceral proteins

作　　者：杨俊省[1] 张建立[1] 

机构地区：[1]青岛大学医学院附属医院,山东青岛266003

出　　处：《腹腔镜外科杂志》2009年第12期922-924,共3页Journal of Laparoscopic Surgery

摘　　要：目的：探讨腹腔镜直肠癌Miles手术对机体应激反应和内脏蛋白的影响。方法：将60例行直肠癌Miles手术的患者按其意愿分为腹腔镜组和开腹组,每组30例,于术前、术后第1、2、3天晨检测血C反应蛋白（CRP）,IL-6及内脏蛋白,包括白蛋白（ALB）、前白蛋白（PRE）、转铁蛋白（TRF）、视黄醇结合蛋白（RBP）的变化。结果：两组CRP、IL-6术后1~3d较术前均明显升高（P〈0.01）,腹腔镜组术后CRP、IL-6明显低于开腹组（P〈0.01）。两组术后ALB、PRE、TRF、RBP较术前明显下降（P〈0.01）。术后第2天腹腔镜组PRE高于开腹组（P〈0.01）,术后第3天腹腔镜组ALB、PRE、TRF、RBP均明显高于开腹组（P〈0.01）。结论：腹腔镜直肠癌Miles手术较开腹手术机体创伤及应激反应小,有利于机体内脏蛋白的恢复。Objective：To investigate the method and feasibility of laparoscopic partial gastrectomy for small gastric carcinoid tumors combined with C arm radiotherapy machine.Methods：The clinical data of 7 patients,who were diagnosed as small gastric carcinoid tumors and treated by laparoscopic partial gastrectomy combined with C arm radiotherapy machine,were retrospectively analyzed.Results：All cases underwent laparoscopy successfully,without surgery related complications.Their diagnoses were confirmed by postoperative pathologic examination.During the follow up period of 10 months to 6 years,all patients were rechecked with gastroscope and discovered in good health.No recurrence of gastric carcinoid tumor or metastasis occurred.Conclusions：The laparoscopic partial gastrectomy combined with C arm radiotherapy machine is feasible for small gastric carcinoid tumors and has obvious superiority compared to conventional open surgery,such as less trauma and complications.Surgeons must strictly grasp the indications and main points of laparoscopy.

关 键 词：直肠肿瘤 腹腔镜检查 应激 内脏蛋白 

分 类 号：R735.37[医药卫生—肿瘤]