两种术式治疗结肠癌患者的临床疗效及血清胃泌素、肝细胞生长因子变化水平比较  

Comparison of the Clinical Effect and Serum Gastrin and Hepatocyte Growth Factor Level Changes of Two Kinds of Operation Treating Colon Cancer

作　　者：白景舒[1] 辛革[1] 王楠[1] 罗绍莲[1] 

机构地区：[1]大连大学附属新华医院肛肠科,辽宁大连116021

出　　处：《医学综述》2016年第2期377-380,共4页Medical Recapitulate

摘　　要：目的比较两种术式治疗结肠癌患者的临床疗效及血清胃泌素、肝细胞生长因子变化水平。方法选择2012年5月至2015年5月大连大学附属新华医院肛肠科收治的80例结肠癌患者作为研究对象,按照随机数字表法分为治疗1组(40例)和治疗2组(40例),两组患者均行分期手术,治疗1组Ⅰ期行回肠袢式造口术,治疗2组Ⅰ期行结肠造口术,术后3个月两组均再行Ⅱ期造口闭合术。比较两组患者Ⅰ期、Ⅱ期的手术时间、首次排气时间、住院时间及并发症发生率;分别于Ⅰ期和Ⅱ期术前、术后1d、术后3d、术后7 d检测两组患者血清胃泌素、肝细胞生长因子水平。结果治疗1组Ⅰ期手术首次排气时间[(2.5±0.6)d]显著短于治疗2组[(4.5±0.8)d],差异有统计学意义(P<0.05);治疗1组Ⅱ期手术时间[(1.3±0.4)min]、首次排气时间[(3.1±0.6)d]、住院时间[(6.2±1.3)d]均显著短于治疗2组[(2.4±0.3)min、(4.9±0.9)d、(8.8±1.9)d],差异有统计学意义(P<0.05)。两组患者Ⅰ期、Ⅱ期术后血清胃泌素、肝细胞生长因子均显著降低,与术前比较差异有统计学意义(P<0.05);两组间手术前后各时段胃泌素、肝细胞生长因子比较差异无统计学意义(P>0.05)。两组患者Ⅰ期并发症发生率比较差异无统计学意义(P>0.05),Ⅱ期手术治疗1组低钾血症发生率(5.0%)显著低于治疗2组(20.0%)(P<0.05)。结论回肠袢式造口术和结肠造口术治疗结肠癌疗效相当,但回肠袢式造口术创伤小、患者胃肠功能恢复快,且并发症发生率低,临床优势更明显。Objective To compare the clinical effect and serum gastrin and hepatooyte growth factor level changes of two kinds of operation for colon cancer. Methods A total of 80 cases of colon cancer treated in Xinhua Hospital Affiliated to Dalian University from May 2012 to May 2015 were divided into treatment 1 group of 40 cases and treatment 2 group of 40 cases according to random number table method, both groups underwent staged operation：treatment 1 group received loop ileostomy in phase I , treatment 2 group underwent Hartmann operation in phase I, 3 months lator, both groups received stoma closure in phase Ⅱ. The phase Ⅰ, phase Ⅱ operation time, first exhaust time, hospitalization time and complication rate of the two groups were compared;serum gastrin and hepatocyte growth factor levels before and 3 d,5 d ,7 d after operation in phase Ⅰ, Ⅱ were detected respectively. Results Treatment 1 groupphase I first exhaust time（2.5±0. 6 ） d was significantly shorter than that in the treatment 2 group （4.5±0. 8 ） d （ P 〈 0.05 ） ; treatment 1 group phase Ⅱ operation time （ 1.3±0.4） rain, first time exhaust time （ 3.1±0.6） d, hospitalization time （6. 2 ±1.3 ） d were significantly shorter than that in the treatment 2 group [ （ 2. 4±0. 3 ） rain, （ 4. 9±0. 9 ） d, （ 8.8±1.9） d ] （ P 〈 0. 05 ）. Serum gastrin and hepatocyte growth factor in both group were significantly lower after operation （P 〈 0.05 ）, there was no significant difference in gastrin and hepatocyte growth factor between the two groups before and after operation （ P 〉 0.05 ）. There was no significant difference in the incidence of complications between the two groups during phase I （ P 〉 0.05 ）, and kaliopenia rate dur- ing phase Ⅱ in treatment 1 group （5.0%） was significantly lower than that in the treatment 2 group （20. 0% ） （P 〈 0. 05 ）. Conclusion The clinical effect of loop ileostomy and Hartmann operation in treatment with colon cancer is similar, and loop ileosto

关 键 词：结肠癌 回肠袢式造口术 结肠造口术 胃泌素 肝细胞生长因子 

分 类 号：R615[医药卫生—外科学]