术中肠道灌洗法在梗阻性结肠癌切除术中的应用及对患者免疫功能的影响  

Application of intraoperative colonic lavage and its influence on immune function of patients with obstructive colon cancer

作　　者：高维鸽[1] 阿布都维力·阿布都热合曼 GAO Wei-ge;Abduvili Abdureheman(Department of Anorectal Surgery,Xinjiang Uygur Autonomous Region People's Hospital,Urumqi,Xinjiang 830001,China)

机构地区：[1]新疆维吾尔自治区人民医院肛肠外科,新疆乌鲁木齐830001

出　　处：《中国临床研究》2020年第8期1072-1075,共4页Chinese Journal of Clinical Research

摘　　要：目的探讨梗阻性结肠癌切除手术中肠道灌洗法的应用及对患者免疫功能的影响。方法选取2013年5月至2018年3月收治的梗阻性结肠癌患者96例,按照随机数字表法将患者分为两组,各48例。对照组行梗阻性结肠癌手术治疗,研究组行梗阻性结肠癌手术并配合肠道灌洗治疗,分析对比两组患者的手术情况、并发症发生情况、免疫指标水平变化等。结果术后患者肠功能恢复时间、下床时间以及住院时间研究组短于对照组,手术时间长于对照组(P<0.01);研究组总并发症发生率低于对照组(2.1%vs 25.0%,P<0.01);研究组治疗后白细胞计数(WBC)、淋巴细胞数(LN)、C反应蛋白(CRP)、自然杀伤细胞(NK)、白细胞介素-6(IL-6)、CD4^+、CD8^+等免疫指标水平优于对照组,差异有统计学意义(P<0.05);研究组治疗后高迁移率族蛋白-1(HMGB-1)、单核细胞趋化因子蛋白-1(MCP-1)、丁二醇(BG)以及胰高血糖素水平低于对照组,差异有统计学意义(P<0.05)。结论在针对梗阻性结肠癌患者的治疗过程当中,行梗阻性结肠癌手术并配合肠道灌洗的治疗效果理想。Objective To explore the application of intestinal lavage in resection of obstructive colon cancer and its effect on immune function of patients.Methods A total of 96 patients with obstructive colon cancer operated from May 2013 to March 2018 were selected and randomly divided into control group and study group in which intraoperative intestinal lavage was performed(n=48,each).The operative condition,complications and immune index level changes were analyzed and compared between two groups.Results The recovery time of postoperative bowel function,the time of getting out of bed and the length of hospital stay in study group were significantly shorter than those in control group(P<0.01),and the operation time was significantly longer than that in control group(P<0.01).The complication rate in study group was significantly lower than that in control group(2.1%vs 25.0%,P<0.01).The levels of WBC,lymph,CRP,NK,IL-6 and CD4^+、CD8^+ in study group were statistically better than those in control group(P<0.05).After treatment,the levels of high mobility group protein-1(HMGB-1),monocyte chemoattractant protein-1(MCP-1)and Butylene glycol(BG)and glucagon in study group were significantly lower than those in control group(P<0.05).Conclusion In the treatment of patients with obstructive colon cancer,the curative effect of surgery combined with intro-operative colonic lavage is satisfactory.

关 键 词：梗阻性结肠癌手术 肠道灌洗 免疫功能 应激反应 

分 类 号：R574.2[医药卫生—消化系统]