内镜下套扎切除术治疗直肠类癌的效果及对患者免疫功能的影响分析  

Effect of Endoscopic Ligation Resection on Rectal Carcinoid and Its Effect on Immune Function

作　　者：崔佳宾 CUI Jiabin(Jiamusi Central Hospital,Jiamusi 154002,China)

机构地区：[1]黑龙江省佳木斯市中心医院,黑龙江佳木斯154002

出　　处：《中国医学创新》2021年第35期1-5,共5页Medical Innovation of China

基　　金：黑龙江卫生健康委科研课题(2020-362)。

摘　　要：目的:分析内镜下套扎切除术(ESMRL)治疗直肠类癌的效果,探讨对患者免疫功能的影响。方法:选取2020年5月-2021年5月佳木斯市中心医院确诊的68例直肠类癌患者,根据手术方式的不同,分为ESD组和ESMRL组。ESD组行内镜下黏膜剥离术(ESD),ESMRL组行ESMRL。比较两组手术指标、病理结果、手术前后血清胃动素(MTL)、炎症因子水平和免疫功能,分析并发症发生情况。结果:ESMRL组内镜下完整切除率高于ESD组,术后标本直径大于ESD组,手术时间、首次下床活动时间、住院时间均短于ESD组,术中出血量少于ESD组,差异均有统计学意义(P<0.05)。ESMRL组黏膜下层病变深度比例明显高于ESD组,病理完整切除率高于ESD组,差异均有统计学意义(P<0.05)。术前,两组MTL、炎症因子水平比较,差异均无统计学意义(P>0.05);术后,两组MTL水平均下降,ESMRL组高于ESD组(P<0.05);术后,两组IL-6和CRP均升高,ESMRL组均低于ESD组,差异均有统计学意义(P<0.05)。术后,两组CD4^(+)、CD8^(+)和CD3^(+)均下降,ESMRL组均明显高于ESD组,差异均有统计学意义(P<0.05)。ESMRL组并发症发生率虽低于ESD组,但差异无统计学意义(P>0.05)。结论:病变深度限于黏膜下层行ESMRL治疗的直肠类癌患者内镜下完整切除率高,术后标本直径大,手术时间缩短,临床指标改善,病理完整切除率较高,炎症反应减轻,免疫抑制减轻,术后并发症发生率低。Objective:To analyze the effect of endoscopic ligation resection (ESMRL) in the treatment of rectal carcinoid and its effect on immune function.Method:A total of 68 patients with rectal carcinoid diagnosed in Jiamusi Central Hospital from May 2020 to May 2021 were selected and divided into ESD group and ESMRL group according to different surgical methods.The ESD group underwent endoscopic mucosal dissection (ESD),and the ESMRL group underwent endoscopic ligation resection (ESMRL).The surgical indexes,pathological results,MTL,inflammatory factor levels and immune function before and after operation were compared between the two groups,and the incidence of complications was analyzed.Result:The complete resection rate under endoscopy in ESMRL group was higher than that in ESD group,the diameter of postoperative specimens was larger than that in ESD group,the operation time,first ambulation time and hospital stay were shorter than those in ESD group,and the amount of intraoperative bleeding was less than that in ESD group (P<0.05).The proportion of submucosal lesion depth in ESMRL group was significantly higher than that in ESD group,and the complete resection rate was higher than that in ESD group,the differences were statistically significant (P<0.05).There were no significant differences in the levels of MTL and inflammatory factors between the two groups before operation (P>0.05);after operation,the levels of MTL in both groups decreased,and that in ESMRL group was higher than that in ESD group (P<0.05);after operation,IL-6 and CRP increased in the two groups,and those of the ESMRL group was lower than those of the ESD group (P<0.05).After operation,CD4^(+),CD8^(+)and CD3^(+)decreased in the two groups,and those of the ESMRL group were significantly higher than those of the ESD group (P<0.05).The incidence of complications in ESMRL group was lower than that in ESD group,but the difference was not statistically significant (P>0.05).Conclusion:Patients with rectal carcinoid whose lesion depth is limited to the subm

关 键 词：直肠类癌 套扎切除术 黏膜剥离术 病理结果 并发症 炎症因子 

分 类 号：R735.37[医药卫生—肿瘤]