TATME对直肠癌患者Th1/Th2及肠道菌群的影响  

Effects of TATME on Th1/Th2 and intestinal flora in patients with rectal cancer

作　　者：邓超[1] 冷蔚 方仕旭 马勇[1] DENG Chao;LENG Wei;FANG Shixu(Department of General Surgery,The First People’s Hospital of Zigong City,Sichuan,Zigong 643000,China)

机构地区：[1]四川省自贡市第一人民医院普外科,643000

出　　处：《河北医药》2021年第8期1174-1178,共5页Hebei Medical Journal

摘　　要：目的探讨经肛全直肠系膜切除术(TATME)对直肠癌患者Th1/Th2及肠道菌群的影响。方法选取2018年1月至2019年4月直肠癌患者102例,依据随机数字表法分为研究组与对照组,每组51例。对照组采取传统腹腔镜手术,研究组采取TATME。统计2组围术期状况、肛门功能优良率、手术前后肠道菌群、Th1/Th2、并发症,随访12个月统计2组生存率。结果术中失血量研究组少于对照组,引流管拔除时间、首次下床活动时间、住院时间短于对照组(P<0.05);肛门功能优良率组间比较,研究组(94.12%)高于对照组(78.43%)(P<0.05);研究组术后第1天乳杆菌、拟杆菌、双歧杆菌水平高于对照组,肠杆菌、肠球菌水平低于对照组(P<0.05),但术后1周2组比较无显著差异(P>0.05);研究组术后第1 dTh1、Th1/Th2水平高于对照组,Th2水平低于对照组(P<0.05),但术后1周2组比较无显著差异(P>0.05);研究组并发症发生率(3.92%)低于对照组(15.69%)(P<0.05);研究组术后6个月、9个月生存率(97.96%、93.88%)与对照组(91.67%、87.50%)间无显著差异(P>0.05),研究组术后12个月生存率(89.80%)高于对照组(72.92%)(P<0.05)。结论采取TATME治疗直肠癌创伤小,且对患者机体免疫及肠道菌群损害小、恢复快,肛门功能优良率较高,还可提升患者生存率,且并发症发生率较低,具有安全性。Objective To investigate the effects of transanal total mesorectal excision(TATME)on the Th1/Th2 and intestinal flora of patients with rectal cancer.Methods A total of 102 patients with rectal cancer who were treated in our hospital from January 2018 to April 2019 were enrolled in the study,who were divided into the research group(n=51)and the control group(n=51)according to the random number table method.The patients in control group were treated by traditional laparoscopic surgery,however,the patients in research group were treated by TATME.The perioperative status,the excellent and good rate of anal function,the intestinal flora before and after the operation,Th1/Th2,complications as well as the survival rate after 12-month follow-up were observed and compared between the two groups.Results The intraoperative blood loss,and the drainage tube removal time,the first time of off-bed activity and the length of staying in hospital in research group were significantly less than those in control group(P<0.05).The good/excellent rate of anal function in research group was 94.12%,which was significantly higher than that(78.43%)in control group(P<0.05).The levels of lactobacillus,bacteroides,and bifidobacteria at 1d after surgery in research group were significantly higher than those in control group,however,the levels of enterobacter and enterococcus were significantly lower than those in control group(P<0.05),moreover,there were no significant differences at 1 week after surgery between the two groups(P>0.05).The levels of Th1 and Th1/Th2 at 1d after surgery in research group were significantly higher than those in control group,while the Th2 levels were significantly lower than those in control group(P<0.05).The incidence of complication in research group was 3.92%,which was significantly lower than that(15.69%)in control group(P<0.05).Moreover there were no significant differences in 6-month and 9-month survival rates after surgery between the two groups(P>0.05),however,the 12-month survival rate in research group w

关 键 词：TATME 直肠癌 TH1/TH2 肠道菌群 肛门功能 

分 类 号：R735.37[医药卫生—肿瘤]