内镜黏膜下剥离术治疗结直肠间质瘤患者的临床效果及对免疫功能、生理应激的影响  

The effect of ESD in the treatment of patients with colorectal stromal tumor and its influence on immune function and physiological stress

作　　者：张乙川 李玲 杨成俊 王飞 刘珂良 ZHANG Yi-chuan;LI Ling;YANG Cheng-jun;WANG Fei;LIU Ke-liang(Digestive Disease Center,The Affiliated Hospital of Panzhihua University,Panzhihua 617000,China)

机构地区：[1]攀枝花学院附属医院消化疾病中心,四川攀枝花617000

出　　处：《实用医院临床杂志》2021年第6期191-194,共4页Practical Journal of Clinical Medicine

摘　　要：目的观察内镜黏膜下剥离术(ESD)治疗结直肠间质瘤患者的临床疗效及对其免疫功能、生理应激的影响。方法我院就诊的183例结直肠间质瘤患者,依据手术方式分为ESD组(n=91)和对照组(n=92),对照组行腹腔镜术,ESD组行ESD术。观察两组术后恢复情况、手术前后免疫功能、围术期生理应激指标、术后并发症发生率及术后1年生存率和复发率。结果ESD组手术时间、术中出血量、术后进食时间、术后首次排气时间和住院时间均短于对照组(P<0.05);术后1 d,ESD组血清去甲肾上腺素(NE)和皮质醇(Cor)水平均低于对照组(P<0.05);术后3 d,ESD组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)高于对照组,CD8^(+)低于对照组(P<0.05);两组并发症发生率、术后1年生存率和复发率比较,差异无统计学意义(P>0.05)。结论ESD术治疗结直肠间质瘤患者临床疗效明显,可有效促进患者术后康复,减轻手术对机体免疫功能和生理应激的影响。Objective To observe the clinical effect of endoscopic submucosal dissection(ESD)in the treatment of patients with colorectal stromal tumor and its influence on immune function and physiological stress.Methods One hundred and eighty-three patients with colorectal stromal tumor treated in our hospital were analyzed retrospectively.According to the mode of operation,the patients were divided into an ESD group(n=91)and a control group(n=92).Laparoscopy was performed in the control group and ESD was performed in the ESD group.The postoperative recovery,immune function before and after operation,perioperative physiological stress indexes,incidence of postoperative complications,1-year survival rate and recurrence rate after operation were observed and compared between the two groups.Results The operation time,intraoperative blood loss,postoperative food intake,postoperative first exhaust time and hospital stay in the ESD group were significantly shorter or less than those in the control group(P<0.05).On the first day after operation,the levels of serum norepinephrine(NE)and cortisol(Cor)in the ESD group were significantly lower than those in the control group(P<0.05).On the third day after operation,CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in the ESD group were significantly higher than those in the control group,while CD8^(+)in the ESD group was significantly lower than that in the control group(P<0.05).However,there were no significant differences in the incidence of complications,1-year survival rate and recurrence rate of patients between the two groups(P>0.05).Conclusion ESD has an obvious clinical effect in the treatment of patients with colorectal stromal tumor.It can effectively promote the postoperative recovery and reduce the influence of operation on immune function and physiological stress of the patients.

关 键 词：内镜黏膜下剥离术 结直肠间质瘤 免疫功能 生理应激 

分 类 号：R735.3[医药卫生—肿瘤]