腹腔镜结肠癌根治性手术的临床疗效及对血清电解质、血红素氧化酶-1和人类软骨糖蛋白39的影响  

Clinical effect of laparoscopic radical colectomy and the impact on serum electrolytes,heme oxygenase-1 and human cartilage glycoprotein 39

作　　者：徐新强 朱共元 徐建国 黄勇[1] XU Xinqiang;ZHU Gongyuan;XU Jianguo;HUANG Yong(Department of General Surgery,Heyuan People’s Hospital(Heyuan Hospital Affiliated to Ji’nan University),Heyuan 517000,Guangdong,China)

机构地区：[1]河源市人民医院(暨南大学附属河源医院)普外科,广东河源5170000

出　　处：《癌症进展》2020年第11期1152-1154,1170,共4页Oncology Progress

摘　　要：目的探讨腹腔镜结肠癌根治性手术的临床疗效及对患者血清电解质、血红素氧化酶-1(HO-1)、人类软骨糖蛋白39(YKL-40)的影响。方法采用随机数字表法将114例结肠癌患者分为腹腔镜组和对照组,每组57例,腹腔镜组患者采用腹腔镜结肠癌根治性手术,对照组患者采用传统开腹手术。比较两组患者的围手术期指标,术前及术后24 h的血清钙离子、钾离子、钠离子、总蛋白(TP)、白蛋白(ALB)、前白蛋白(PA)、HO-1、YKL-40水平。结果腹腔镜组患者的手术时间长于对照组,术中出血量少于对照组,首次肠道排气时间和住院时间均短于对照组,差异均有统计学意义(P﹤0.05)。术前,两组患者的血清钠离子、钾离子、钙离子、TP、ALB、PA水平比较,差异均无统计学意义(P﹥0.05);术后24 h,腹腔镜组患者的钠离子、TP、ALB水平均高于对照组,差异均有统计学意义(P﹤0.05)。术前,腹腔镜组和对照组患者的血清HO-1、YKL-40水平比较,差异均无统计学意义(P﹥0.05);术后24 h,腹腔镜组患者的血清HO-1、YKL-40水平均明显低于对照组,差异均有统计学意义(P﹤0.01)。结论腹腔镜结肠癌根治性手术治疗结肠癌较传统开腹手术创伤小,且炎性、应激反应以及第三间隙效应更轻微。Objective To investigate the clinical effect of laparoscopic radical colectomy and the impact on serum electrolytes,heme oxygenase-1(HO-1)and human cartilage glycoprotein 39(YKL-40).Method A random number table was employed to divide 114 patients with colon cancer into laparoscopic surgery group or control group,with 57 cases in each,laparoscopic colectomy and traditional open surgery were administered for patients in each group.The perioperative measures,serum calcium,potassium,sodium,total protein(TP),albumin(ALB),prealbumin(PA),HO-1 and YKL-40 before surgery and 24 h after surgery were compared between the two groups of patients.Result Extended operative time,less intraoperative hemorrhage,and shorter time to first bowel exhaust as well as reduced length of hospital stay were observed in the laparoscopic surgery group compared to control group(P<0.05).Before surgery,there were no significant differences in serum calcium,potassium,sodium,TP,ALB and PA levels between the two groups(P>0.05);24 h after surgery,the serum sodium,TP and ALB levels in laparoscopic surgery group were evidently higher than those in the control group(P<0.05).Similar levels of serum HO-1 and YKL-40 were noted between the laparoscopic surgery group and the control group before surgery(P>0.05);and in 24 h after surgery,the serum HO-1 and YKL-40 levels were significantly lower in patients receiving laparoscopic surgery than in those underwent traditional open surgery(P<0.05).Conclusion Laparoscopic radical colectomy is with minor incision and milder inflammatory and stress responses as well as less third-spacing as compared with traditional open surgery.

关 键 词：腹腔镜结肠癌根治性手术 电解质 血红素氧化酶-1 人类软骨糖蛋白39 

分 类 号：R735.3[医药卫生—肿瘤]