腹腔镜治疗结直肠癌的临床疗效及对肿瘤标志物的影响  

Clinical efficacy of laparoscopic surgery for colorectal cancer and the effects on tumor markers

作　　者：谢景军[1] 张建峰[2] 王亚利 孙常青 王怀志[1] XIE Jing-jun;ZHANG Jian-feng;WANG Ya-li;SUN Chang-qing;WANG Huai-zhi(Department of General Surgery,Henan Armed Police Corps Hospital,Zhengzhou 450002,China;Department of Health Service,Henan Armed Police Corps Hospital,Zhengzhou 450002,China)

机构地区：[1]武警河南总队医院普通外科,郑州450002 [2]武警河南总队医院卫勤处,郑州450002

出　　处：《中国肿瘤临床与康复》2020年第6期707-711,共5页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨腹腔镜微创术治疗结直肠癌患者的临床疗效及对血清癌胚抗原(CEA)、糖类抗原19-1(CA19-9)和糖类抗原242(CA242)的影响。方法选取2017年1月至2019年12月间武警河南总队医院收治的200例结直肠癌患者,根据治疗方法不同进行分组,其中,采用开腹手术治疗的100例患者纳入对照组,采用腹腔镜微创术治疗的100例患者纳入研究组。比较两组患者的手术结果、治疗效果、并发症、血清CEA、CA19-9和CA242含量及生活质量评分。结果研究组手术时间长于对照组,且切口长度、住院天数和术中出血量均优于对照组,差异均有统计学意义(均P<0.05);两组患者淋巴结清扫数比较,差异无统计学意义(P>0.05)。研究组患者治疗效果高于对照组,术后并发症少于对照组,差异均有统计学意义(均P<0.05)。治疗前,两组患者的CEA、CA19-9和CA24水平比较,差异无统计学意义(P>0.05),治疗后,研究组患者CEA、CA19-9和CA24水平均优于对照组,差异均有统计学意义(均P<0.05)。术前,两组患者生活质量评分比较,差异无统计学意义(P>0.05),术后7d、30d及60d,研究组患者的生活质量评分均高于对照组,差异均有统计学意义(均P<0.05)。结论应用腹腔镜微创术治疗结直肠癌疗效较好,可以降低血清中CEA、CA19-9和CA242含量,改善患者生活质量,值得临床大力推广。Objective To investigate the efficacy of laparoscopic minimally invasive surgery for colorectal cancer and the effects on serum carcinoembryonic antigen(CEA),carbohydrate antigen 19-1(CA19-9)and CA242.Methods Two hundred patients with colorectal cancer who admitted to Henan Armed Police Corps Hospital from January 2017 to December 2019 were selected and divided into two groups based on the treatment they received.One hundred patients who underwent laparoscopic minimally invasive surgery were included in a study group and 100 patients who underwent laparotomy were included in a control group.The results of surgery,therapeutic effect,complications,serum CEA,ca19-9,CA242 and quality of life scores were compared.Results The operation time was longer in the study group than in the control group(all P<0.05).However,the incision length,length of hospital stay and intraoperative blood loss were better in the study group than in the control group(all P<0.05).There was no significant difference in the number of lymph nodes dissected between the two groups(P>0.05).The treatment efficacy was higher in the study group than in the control group(P<0.05),and the postoperative complications were less in the study group than in the control group(P<0.05).Before the treatment,there was no significant difference in CEA,ca19-9 and CA24 levels between the two groups(P>0.05).After treatment,CEA,ca19-9 and CA24 levels were significantly better in the study group than in the control group(all P<0.05).There was no significant difference in the quality of life scores between the two groups(P>0.05),and the postoperative quality of life scores were significantly higher in the study group than in the control group at 7 d,30 d and 60 d after the surgery(P<0.05).Conclusion Laparoscopic minimally invasive surgery is effective in the treatment of colorectal cancer,which can reduce the serum contents of CEA,ca19-9 and CA242 and improve quality of life.

关 键 词：腹腔镜微创术 结直肠肿瘤 治疗效果 癌胚抗原 糖类抗原19-9 糖类抗原242 

分 类 号：R735.3[医药卫生—肿瘤]