腹腔镜治疗直肠癌效果及对患者应激反应、免疫功能、恶性生物学行为和生活质量的影响  被引量:12

Influence of Laparoscopic Surgery on Stress Response,Immune Function,Malignant Biological Behavior and Life Quality in Treating Rectal Cancer

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作  者:孔连广 吕祥[1] 张洪涛[1] 王淡川 麦伟锦[1] 冯锦杭 植焕真 苏刚岭[1] 郑祥珍 曹杰智[1] 

机构地区:[1]广州市白云区中医医院,广东广州510470

出  处:《中国医学创新》2016年第27期36-41,共6页Medical Innovation of China

摘  要:目的:研究腹腔镜治疗直肠癌效果及对患者应激反应、免疫功能、恶性生物学行为和生活质量的影响。方法:选取2011年5月-2013年1月本院收治的70例直肠癌患者作为研究对象,随机分为观察组和对照组,每组35例。观察组接受腹腔镜手术,对照组接受常规开腹手术治疗,术后均随访3年。比较两组患者手术近期疗效、远期疗效、并发症发生情况、手术前后相关临床指标变化情况及术后生活质量。结果:两组患者术中清扫淋巴结数目比较差异无统计学意义(P>0.05),观察组手术时间、术中出血量、肛门排气时间及术后住院时间均低于对照组,保肛率高于对照组,比较差异均有统计学意义(P<0.05);观察组并发症发生率为8.57%,低于对照组的31.43%,比较差异有统计学意义(P<0.05);观察组肿瘤死亡率、3年累积生存率、无病生存率均优于对照组,比较差异均有统计学意义(P<0.05);两组患者术后皮质醇(Cor)、C反应蛋白(CRP)、白介素-6(IL-6)及白介素-10(IL-10)水平均升高,还原型谷胱甘肽(GSH)、超氧化物歧化酶(SOD)、肿瘤坏死因子(TNF-α)、γ-干扰素(INF-γ)、血管内皮生长因子(VEGF)、酸性成纤维生长因子(a FGF)及碱性成纤维生长因子(b FGF)水平均降低,观察组术后Cor、CRP、IL-6、IL-10、VEGF、a FGF及b FGF水平均低于对照组,GSH、SOD、TNF-α及INF-γ水平均高于对照组,比较差异均有统计学意义(P<0.05);观察组术后各项生活质量评分均高于对照组(P<0.01)。结论:腹腔镜治疗直肠癌效果显著,安全性高,患者术后应激反应及免疫抑制轻,有助于遏制恶性生物学行为,提高患者生活质量,值得临床推广应用。Objective: To research the influence of laparoscopic surgery on stress response, immune function, malignant biological behavior and life quality in treating rectal cancer.Method: From May 2011 to January 2013, 70 cases of rectal cancer were divided into the observation group and the control group, each group had 35 cases.The observation group received laparoscopic surgery and the control group received conventional open surgery with a follow-up of 3 years.The differences of the short-term effects, the long-term effects, complication occurrence, changes of related clinical indexes before and after surgery and quality of life after surgery were compared.Result: There was no significant difference in the number of lymph node dissection of two groups (P〉0.05), the operation time, bleeding volume, anal exhaust time and postoperative hospital stay of the observation group were lower than those of the control group, anus preservation rate was higher than that of the control group, the differences were statistically significant ( P〈0.05 ) .The total complication rate of the observation group was 8.57%, which was lower than 31.43% of the control group, the difference was statistically significant (P〈0.05) .The tumor mortality rate, 3 year cumulative survival rate and disease-free survival rate of the observation group were better than those of the control group, the differences were statistically significant ( P〈0.05 ). Two groups postoperative cortisol ( COR ), C-reactive protein ( CRP ), interleukin 6 ( IL-6 ) and interleukin 10 ( IL-10 ) levels were elevated, reduced glutathione ( GSH ), superoxide dismutase ( SOD ), tumor necrosis factor- α ( TNF- α ) and γ-interferon ( INF- γ ), vascular endothelial growth factor ( VEGF ) and acidic fibroblast growth factor ( aFGF ) and basic fibroblast growth factor ( bFGF ) levels were decreased, Cor, CRP, IL-6, IL- 10, VEGF, aFGF and bFGF levels in the observation group were lower than those of the contr

关 键 词:腹腔镜 直肠癌 应激反应 免疫功能 恶性生物学行为 生活质量 

分 类 号:R735.37[医药卫生—肿瘤]

 

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