腹腔镜直肠癌根治术对胃肠功能及肛肠动力学的影响  

Effect of laparoscopic radical resection of rectal cancer on gastrointestinal function and anorectal dynamics

作　　者：贺雄辉 邹科见[1] 叶木林[1] 蔡国豪[1] 周卫平[1] He Xionghui;Zou Kejian;Ye Mulin;Cai Guohao;Zhou Weiping(Department of Gastrointestinal Surgery,People＇s Hospital of Hainan Province,Hainan Haikou 570311,China.)

机构地区：[1]海南省人民医院胃肠外二科,海南海口570311

出　　处：《现代肿瘤医学》2018年第20期3256-3259,共4页Journal of Modern Oncology

基　　金：海南省自然科学基金项目(编号:20168290)

摘　　要：目的:探讨腹腔镜直肠癌根治术后对患者胃肠功能和肛肠动力学产生的影响。方法:将我院自2015年1月至2017年1月间收治的行直肠癌根治术患者94例作为研究对象,按照随机数字表法分为研究组和对照组各47例,研究组患者行腹腔镜直肠癌根治术,对照组患者行传统开放式手术进行治疗,观察两组患者胃肠功能和肛肠动力学等指标的变化情况。结果:治疗后两组患者GAS、MTL、VIP等指标水平呈先降低后上升的"正V"趋势,在术后第1天和第7天明显低于治疗前,但是研究组患者各项指标变化情况相对于对照组来说比较稳定,在第14天研究组患者各项指标基本恢复至正常水平,而对照组明显低于治疗前,差异具有统计学意义(P <0. 05),组间比较差异具有统计学意义(P <0. 05);治疗后ARP、MSP、HPZ、MTV均在2周内明显降低,1个月后又开始逐渐升高,RRP和AIRT则先升高后降低,差异具有统计学意义(P <0. 05),术后3个月、6个月时两组患者各项指标比较差异无统计学意义(P> 0. 05),治疗前后APWF水平无明显变化。手术后,研究组患者的排气时间、进食时间和排便时间均低于对照组,差异具有统计学意义(P <0. 05)。结论:腹腔镜手术相对于传统开腹手术来说对患者的胃肠功能和肛肠动力学造成的影响更小,腹腔镜直肠癌根治术是安全有效的。Objective：To investigate the effect of laparoscopic radical resection of rectal cancer on gastrointestinal function and anorectal dynamics in patients. Methods ： A total of 94 patients underwent radical resection of rectal cancer from January 2015 to January 2017 were enrolled in this study,and divided into study group and control group according to the random number table method ,47 patients in each group. The patients in study group underwent radi-cal resection of the rectal cancer and the patients in control group underwent traditional open surgery. The changes of gastrointestinal function and anorectal dynamics were observed. Results：GAS, MTL,VIP levels of the two groups after treatment in patients were decreased first and then increased which showed ＂ V＂ trend. These of d1 and d7 after opera-tion were significantly lower than that before treatment, but the changes of study group indicators compared to the control group were relatively stable. In the d14, study group indicators were recovered to normal level, while those of the control group were significantly lower than that before treatment. The difference was statistically significant （P 〈 0.05）. ARP, MSP, HPZ and MTV in 2 weeks after treatment were obviously decreased and were gradually in-creased after 1 month. RRP and AIRT were increased, then decreased, and the difference was statistically significant （ P 〈 0.05 ）. No statistical significance was found in 3 months and 6 months after treatment （ P 〉 0.05 ）. No signifi- cant changes were found in APWF level before and after treatment. The postoperative anus exhaust time, liquid diet time and defecation time were shorter than those of the control group （ P 〈 0.05 ）. Conclusion ： Laparoscopic radical resection of rectal cancer has a significant effect on the gastrointestinal function and anorectal dynamics of patients, but it can be recovered quickly after operation. It can be proved that laparoscopic radical resection of rectal cancer is safe and effective.

关 键 词：直肠癌 根治术 腹腔镜 胃肠功能 肛肠动力学 

分 类 号：R735.37[医药卫生—肿瘤]