经腹膜外腹腔镜前列腺癌根治术围术期指标观察及其对患者的影响  

Perioperative indices of extraperitoneal laparoscopic radical prostatectomy and their effects on patients

作　　者：农健[1] 吴新潮[1] 何慈聪[1] 黄文林[1] 李涛[1] 杨爱宏[1] NONG Jian;WU Xinchao;HE Cicong;HUANG Wenlin;LI Tao;YANG Aihong(Yunnan Wenshan Prefecture People′s Hospital,Wenshan,Yunnan 663000,China)

机构地区：[1]云南省文山州人民医院

出　　处：《国际检验医学杂志》2019年第21期2654-2657,2662,共5页International Journal of Laboratory Medicine

摘　　要：目的探讨经腹膜外腹腔镜前列腺癌根治术围术期指标情况及其对患者总前列腺特异抗原(TPSA)、游离前列腺特异抗原(FPSA)及免疫功能的影响。方法选取2016年3月至2017年3月在该院行前列腺癌根治术的患者92例作为研究对象,随机分为对照组和观察组,每组46例。对照组采用腹腔入路腹腔镜前列腺癌根治术,观察组采用经腹膜外腹腔镜前列腺癌根治术,比较2组患者围术期指标情况,比较2组患者术前及术后血清TPSA、FPSA、IgG、IgA、IgM水平以及CD4^+、CD8^+、CD4^+/CD8^+百分比,比较2组患者术后并发症情况。结果观察组患者围术期手术时间、术中出血量、胃肠功能恢复时间以及住院时间均明显低于对照组,差异有统计学意义(P<0.05);2组患者术后1 d、7 d血清TPSA、FPSA水平较术前均明显降低,且观察组明显低于对照组,差异均有统计学意义(P<0.05);2组患者术后1 d血清IgG、IgA水平及CD4^+、CD4^+/CD8^+百分比较术前均明显降低,CD8^+百分比较术前均明显升高,组间比较差异均有统计学意义(P<0.05);2组患者术后7 d血清IgG、IgA水平及CD4^+、CD4^+/CD8^+百分比较术后1 d均明显升高,CD8^+百分比较术后1 d均明显降低,组间比较差异均有统计学意义(P<0.05);2组患者血清IgM水平术前术后及组间比较差异无统计学意义(P>0.05);观察组患者术后尿失禁、尿道狭窄、尿潴留、勃起功能障碍发生率明显低于对照组,差异有统计学意义(χ2=9.95,P=0.00)。结论经腹膜外腹腔镜前列腺癌根治术对前列腺癌患者临床疗效显著,可有效改善患者围术期指标,降低患者血清TPSA、FPSA水平,改善患者免疫功能,且术后并发症更少,值得临床推广使用。Objective To investigate the perioperative indicators of extraperitoneal laparoscopic radical prostatectomy and their effects on total prostate specific antigen(TPSA),free prostate specific antigen(FPSA)and immune function in patients with prostate cancer.Methods From March 2016 to March 2017,92 patients undergoing radical prostatectomy in our hospital were randomly divided into control group and observation group,46 cases in each group.The control group was treated with laparoscopic radical prostatectomy via abdominal approach,while the observation group was treated with extraperitoneal laparoscopic radical prostatectomy.Perioperative indicators were compared between the two groups.The levels of serum TPSA,FPSA,IgG,IgA,IgM and the percentage of CD4^+,CD8^+,CD4^+/CD8^+before and after operation were compared between the two groups.Results The perioperative operation time,intraoperative bleeding volume,gastrointestinal function recovery time and hospitalization time of the patients in the observation group were significantly lower than those in the control group(P<0.05).The levels of TPSA and FPSA in serum of the two groups on the 1 d and 7 d after operation were significantly lower than those before operation,and those in the observation group were significantly lower than those in the control group(P<0.05).The levels of serum IgG,IgA and the percentages of CD4^+,CD4^+/CD8^+in the two groups at 1 d after operation were significantly lower than those before operation,and the percentages of CD8^+were significantly higher than those before operation(P<0.05).The levels of serum IgG,IgA and the percentage of CD4^+,CD4^+/CD8^+in the two groups increased significantly on the 7 d after operation compared with the 1 d after operation,and the percentage of CD8^+decreased significantly on the 1 d after operation(P<0.05).There was no significant difference in serum IgM level between the two groups before and after operation(P>0.05).The incidence of postoperative incontinence,urethral stricture,urinary retention and erectile

关 键 词：前列腺癌 经腹膜外入路 总前列腺特异抗原 游离前列腺特异抗原 免疫功能 

分 类 号：R615、R737.25[医药卫生—外科学] R737.25[医药卫生—临床医学]