腹腔镜辅助结直肠癌根治术治疗结直肠癌的疗效及对患者营养水平、机体免疫状态的影响  

Clinical effects of laparoscopy-assisted radical resection of colorectal cancer and its effect on nutritional level and immune status of patients

作　　者：王勇 余应筠 郑祖文 刘伟 WANG Yong;YU Yingyun;ZHENG Zuwen;LIU Wei(Department of General Surgery,Chengdu Aerospace Hospital,Chengdu 610100,Sichuan,China;Department of Science and Education,Chengdu Aerospace Hospital,Chengdu 610100,Sichuan,China)

机构地区：[1]成都市航天医院普外科,成都6101000 [2]成都市航天医院科教处,成都6101000

出　　处：《癌症进展》2019年第5期595-598,共4页Oncology Progress

摘　　要：目的观察腹腔镜辅助结直肠癌根治术对结直肠癌患者的临床疗效,分析结直肠癌患者手术前后营养水平与机体免疫状态的变化情况。方法回顾性分析92例结直肠癌患者的临床资料,根据手术方法的不同将患者分为研究组与对照组,每组46例。研究组患者行腹腔镜辅助结直肠癌根治术,对照组患者行常规开腹手术。观察两组患者的围手术期指标(手术时间、术中出血量、术后排气时间、术后住院时间),采用免疫混悬计检测法检测两组患者的术后机体免疫指标[自然杀伤(NK)细胞、C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]和营养指标[白蛋白(ALB)、血红蛋白(Hb)、转铁蛋白(TRF)、前白蛋白(PRE)、视黄醇结合蛋白(RBP)]。结果研究组患者的术中出血量明显低于对照组患者,术后排气时间和术后住院时间均明显短于对照组患者,手术时间明显长于对照组患者(P﹤0.01)。术后7天,对照组患者的ALB、Hb、TRF、PRE、RBP水平均低于研究组患者(P﹤0.05)。术后7天,研究组患者的CRP、IL-6和TNF-α水平均明显低于对照组患者,NK细胞水平明显高于对照组患者(P﹤0.01)。结论临床中对结直肠癌患者实施腹腔镜手术治疗是可行的,腹腔镜手术对患者机体免疫力的影响较小,且能够促进患者术后机体的恢复,改善患者术后的营养水平,值得临床推广应用。Objective To observe the clinical effect of laparoscopy-assisted radical resection of colorectal cancer and to analyze the changes of nutritional level and immune status before and after operation in patients with colorectal cancer.Method The clinical data of 92 patients with colorectal cancer were retrospectively analyzed.According to the different surgical methods,the patients were divided into study group and control group,with 46 cases in each.Laparoscopy-radical resection of colorectal cancer was performed in the study group,while routine open surgery was administered in the control group.The perioperative indexes(operative time,intraoperative blood loss,time to postoperative anal exhaust,postoperative hospitalization)were observed in the two groups.The immune indexes [natural killer(NK)cells,C-reactive protein(CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)] and nutritional indexes [albumin(ALB),hemoglobin(Hb),transferrin(TRF),prealbumin(PRE),retinol binding protein(RBP)] of the two groups were measured by immunoturbidimetry.Result The volume of intraoperative blood loss in the study group was significantly lower than that in the control group,the time to postoperative anal exhaust and length of hospital stay were significantly shorter than those in the control group,while the operative time was significantly longer than that in the control group(P<0.01).After 7 days of operation,the level of ALB,Hb,TRF,PRE and RBP in the control group were lower than those in the study group(P<0.05).During the same period,the CRP,IL-6 and TNF-α level in study group were significantly decreased compared with control group,while NK cells were higher than that in control group,showing statistically significant difference(P<0.01).Conclusion Laparoscopic surgery is feasible in clinical practice for colorectal cancer patients.Laparoscopic surgery has little effect on the immunity of patients,and it can promote the recovery and improve the nutritional level of patients after operation.

关 键 词：结直肠癌 腹腔镜 营养水平 免疫状态 

分 类 号：R735.3[医药卫生—肿瘤]