对比三种不同手术在治疗结直肠癌患者中的效果分析以及对肺功能的影响  

Comparison of the effects of three different surgical procedures in the treatment of colorectal cancer and the effect on lung function

作　　者：左传同 徐晟伟[2] 鞠青[3] 解思滨 ZUO Chuan-tong;XU Sheng-wei;JU Qing;XIE Si-bin(The Third People’s Hospital of Qingdao, General Surgery Department, Qingdao, Shandong, 266041;The Third People’s Hospital of Qingdao, ICU, Qingdao, Shandong, 266041;The Third People’s Hospital of Qingdao, Hospital Infection -control Department, Qingdao, Shandong, 266041;Qingdao Tumour Hospital Cancer Control Center, Qingdao, Shandong, 266042)

机构地区：[1]青岛市第三人民医院普外科,山东青岛266041 [2]青岛市第三人民医院ICU,山东青岛266041 [3]青岛市第三人民医院院感科,山东青岛266041 [4]青岛市肿瘤医院肿瘤防治中心,山东青岛266042

出　　处：《临床普外科电子杂志》2017年第2期22-25,共4页Journal of General Surgery for Clinicians(Electronic Version)

摘　　要：目的对比观察开放结直肠癌手术、气腹腹腔镜结直肠癌手术、无气腹腹腔镜结直肠癌手术对结直肠癌患者的临床治疗效果及对患者肺功能影响情况。方法选取2014年3月至2015年3月青岛市第三人民医院收治的85例结直肠癌患者作为观察对象,所有患者均行手术治疗。根据患者的手术方式将35例采用气腹腹腔镜结直肠癌手术患者分为气腹组,30例采用无气腹腹腔镜结直肠癌手术治疗的患者分为无气腹组,20例采用开放结直肠癌手术治疗的患者分为开腹组。测量气管插管时(T1)、手术开始10分钟(T2)、60分钟(T3)、90分钟(T4)时患者的气道锋压(PIP)、中心静脉压(CVP)及平均动脉压(MAP)、血清p H值、二氧化碳分压(Pa CO2)水平。结果所有患者均成功完成手术,气腹组无中转开放手术患者。T2时,气腹组PIP、CVP水平明显升高,且Pa CO2值随手术时间延长而升高,血清p H值随手术时间延长而降低(P<0.05)。结论气腹腹腔镜结直肠癌手术对患者肺功能有明显影响,不适合有心肺功能障碍的结直肠癌患者选用。无气腹腹腔镜结直肠癌手术具有微创、操作简单、经济实用的特点,值得临床推广。Objective To observe open colorectal surgery,laparoscopic surgery for colorectal cancer,the clinical therapeutic effect of gasless laparoscopic surgery for rectal cancer of node in patients with colorectal cancer and the effect on lung function in the patients.Methods Eighty-fi ve patients with colorectal cancer in our hospital from March2014to2015in March were selected as observation objects,all patients underwent surgical treatment.According to the operation mode of the patients,35patients were divided into two groups,30cases of gasless laparoscopic surgery for colorectal cancer patients were divided into non pneumoperitoneum group,20patients with open colorectal cancer surgery were divided into laparotomy group.Tracheal intubation(T1),the operation began when10min(T2),60min(T3),90min(T4)when the front airway pressure in patients(PIP),central venous pressure(CVP)and mean arterial pressure(MAP),partial pressure of carbon dioxide(PaCO2),the serum pH level of fruit.Results All patients were successfully completed the operation,there was no conversion to open surgery in pneumoperitoneum group.T2,PIP and CVP levels were signifi cantly higher in the pneumoperitoneum group,the PaCO2value increased with the prolongation of operation,serum pH decreased with prolongation of surgery(P<0.05).Conclusion Laparoscopic surgery for colorectal cancer has signifi cant effect on lung function,selection of patients with colorectal cancer who are not suitable for central lung dysfunction.Gasless laparoscopic colorectal cancer surgery has the advantages of minimally invasive,simple operation and economical use.

关 键 词：开放手术 气腹腹腔镜 无气腹腹腔镜手术 结直肠癌患者 肺功能 疗效 

分 类 号：R735.34[医药卫生—肿瘤]