肠减压后腹腔镜下尾侧中间联合入路方法治疗右半结肠癌的效果分析  

Analysis of the effect of laparoscopic caudal middle combined approach after bowel decompression in the treatment of right colon cancer

作　　者：傅厚丰 李炳[1] 梁振雄 刘春桃 FU Hou-feng;LI Bing;LIANG Zhen-xiong(Department of General Surgery,Qionghai People's Hospital,Qionghai Hainan 571400,China.)

机构地区：[1]海南省琼海市人民医院普通外科,海南琼海571400 [2]湖南省第二人民医院肿瘤科,湖南长沙410000

出　　处：《临床和实验医学杂志》2022年第3期307-310,共4页Journal of Clinical and Experimental Medicine

基　　金：海南省医药卫生科研项目(编号:17A000107)。

摘　　要：目的探讨右半结肠癌患者使用肠减压后腹腔镜下尾侧中间联合入路方法的临床疗效。方法前瞻性选取2019年2月至2020年8月琼海市人民医院收治的120例右半结肠癌患者,将其按照随机数字表法均分为两组,每组各60例。对照组采用传统中间入路腹腔镜右半结肠癌根治术,观察组采用尾侧中间联合入路腹腔镜右半结肠癌根治术。观察两组患者手术一般情况,比较两组患者术后胃肠功能恢复、手术应激指标及并发症发生率。结果观察组患者手术时间为(113.58±9.02)min,显著短于对照组[(142.46±8.15)min],术中出血量为(51.47±6.13)mL,少于对照组[(72.61±5.28)mL],差异均有统计学意义(P<0.05)。观察组患者肠鸣音恢复时间、术后排气时间、留置胃管时间和术后进食时间为(20.27±3.46)、(46.54±5.65)、(65.39±5.03)、(78.31±8.36)h,均短于对照组[(23.24±5.03)、(54.52±6.11)、(74.47±5.24)、(85.35±9.54)h],差异均有统计学意义(P<0.05)。术后1 d,观察组患者白细胞介素-6、肿瘤坏死因子α水平分别为(25.82±2.39)、(22.21±3.12)pg/mL,低于对照组[(28.79±2.42)、(24.27±4.45)pg/mL],差异均有统计学意义(P<0.05)。两组患者术后不良反应发生率比较,差异无统计学意义(3.33%vs.5.00%,P>0.05)。结论肠减压后腹腔镜下尾侧中间联合入路方法对右半结肠癌有较好的治疗效果,可缩短手术时间和术后胃肠恢复时间,改善机体炎症反应,具有临床应用的价值。Objective To observe the therapeutic effect of laparoscopic caudal middle combined approach after bowel decompression on patients with right colon cancer.Methods A total of 120 patients with right colon cancer admitted to Qionghai People's Hospital from February 2019 to August 2020 were prospectively selected,and randomly divided into two groups by random number table method,60 cases in each group.The control group was treated with laparoscopic right colon cancer radical resection with traditional middle approach,and the observation group was treated with laparoscopic right colon cancer radical resection with caudal middle combined approach.The general operation situation of the two groups was observed.The postoperative gastrointestinal function recovery,surgical stress indicators and the incidence of complications were compared between the two groups.Results The operation time of the observation group was(113.58±9.02)min,which was significantly shorter than the control group[(142.46±8.15)min],and the intraoperative blood loss was(51.47±6.13)mL,which was less than the control group[(72.61±5.28)mL],the differences were statistically significant(P<0.05).The recovery time of bowel sounds,postoperative exhaust time,indwelling gastric tube time and postoperative eating time in the observation group were(20.27±3.46),(46.54±5.65),(65.39±5.03),(78.31±8.36)h,which were shorter than the control group[(23.24±5.03),(54.52±6.11),(74.47±5.24),(85.35±9.54)h],the differences were statistically significant(P<0.05).One day after operation,the levels of interleukin-6 and tumor necrosis factor alpha in the observation group were(25.82±2.39)and(22.21±3.12)pg/mL,respectively,which were lower than those in the control group[(28.79±2.42)and(24.27±4.45)pg/mL],the differences were statistically significant(P<0.05).There was no statistical difference in the incidence of postoperative adverse reactions between the two groups(3.33%vs.5.00%,P>0.05).Conclusion Laparoscopic caudal middle combined approach after bowel decompressi

关 键 词：结肠癌 肠减压 手术入路 胃肠功能 应激指标 

分 类 号：R735.35[医药卫生—肿瘤]