经肛门内镜显微手术治疗直肠良性肿瘤的价值分析  

Transanal endoscopic microsurgery for benign rectal tumors

作　　者：于锡洋 赵生莹 于文敬 任建华 马克峰 代学峰 Yu Xiyang;Zhao Shengying;Yu Wenjing;Ren Jianhua;Ma Kefeng;Dai Xuefeng(Second Department of General Surgery,Lanshan District People's Hospital,Rizhao 276800,China;Department of Neonatology,Lanshan District People's Hospital,Rizhao 276800,China)

机构地区：[1]日照市岚山区人民医院普外二科,日照276800 [2]日照市岚山区人民医院新生儿科,日照276800

出　　处：《国际医药卫生导报》2022年第11期1586-1591,共6页International Medicine and Health Guidance News

摘　　要：目的探讨经肛门内镜显微手术对直肠良性肿瘤的术后胃肠功能恢复及血清晚期氧化蛋白产物(AOPP)、谷胱甘肽过氧化物酶(GSH-Px)水平的影响。方法选取2017年8月至2019年8月日照市岚山区人民医院直肠良性肿瘤患者73例进行前瞻性研究,按随机数字表法分为显微手术组(37例)和传统手术组(36例)。显微手术组中男22例、女15例,年龄(51.42±5.58)岁;传统手术组中男23例、女13例,年龄(52.26±6.04)岁。显微手术组采取经肛门内镜显微手术,传统手术组采取传统手术。对比两组手术情况、手术疗效、并发症发生率及术前、术后第1天、术后第3天血清氧化应激指标(AOPP、GSH-Px)、胃肠激素指标[血清胃动素(MTL)、胃泌素(GAs)]水平。统计学方法采用独立样本t检验、配对t检验、χ^(2)检验。结果显微手术组术后肠鸣音恢复时间为(5.17±0.94)h、首次肛门排气时间为(6.93±1.72)h、进食时间为(29.31±5.28)h、住院时间为(3.42±0.81)d,均短于传统手术组的(11.62±1.85)h、(15.70±2.14)h、(68.74±11.02)h、(7.60±1.29)d,术中出血量较传统手术组低[(30.53±5.69)ml比(49.17±8.50)ml],两组比较差异均有统计学意义(t=18.855、19.326、19.579、16.629、11.038,均P<0.001);显微手术组总有效率高于传统手术组[97.30%(36/37)比77.78%(28/36)],术后并发症发生率低于传统手术组[8.11%(3/37)比27.78%(10/36)],两组比较差异均有统计学意义(χ^(2)=4.753、4.823,均P<0.05);两组术后第1天、术后第3天血清AOPP水平均较术前提高,但显微手术组均低于传统手术组[(65.11±8.24)μmol/L、(52.48±6.61)μmol/L比(102.58±16.70)μmol/L、(78.12±10.23)μmol/L](t=12.208、12.754,均P<0.001);两组术后第1天、术后第3天血清GSH-Px水平均较术前降低,但显微手术组均高于传统手术组[(126.27±18.59)U/ml、(141.10±22.73)U/ml比(84.91±12.52)U/ml、(104.58±19.65)U/ml](t=11.118、7.335,均P<0.001);两组术后第3天、术后1周血清MTL、GAs水�Objective To investigate the effect of transanal endoscopic microsurgery on postoperative gastrointestinal function recovery and serum advanced oxidized protein product(AOPP)and glutathione peroxidase(GSH-Px)levels in patients with benign rectal tumors.Methods Seventy-three patients with benign rectal tumors treated at Lanshan District People's Hospital from August 2017 to August 2019 were selected for the prospective study and divided into a microsurgery group(37 cases)and a traditional surgery group(36 cases)according to a random number table.There were 22 males and 15 females in the microsurgery group,and they were(51.42±5.58)years old.There were 23 males and 13 females in the traditional surgery group,and they were(52.26±6.04)years old.The microsurgery group underwent transanal endoscopic microsurgery,and the traditional surgery group conventional surgery.The surgical conditions,surgical efficacies,incidences of complications,and serum levels of oxidative stress indicators(AOPP and GSH-Px),and gastrointestinal hormone indicators[serum motilin(MTL)and gastrin(GAs)] before and 1 and 3 days after the operation were compared between the two groups.The independent-sample t test,paired t test,andχ^(2) test were applied.Results The postoperative bowel sound recovery time,first anal flatus time,time to eat,and hospital stay were(5.17±0.94)h,(6.93±1.72)h,(29.31±5.28)h,and(3.42±0.81)d in the microsurgery group,which were shorter than those in the traditional group[(11.62±1.85)h,(15.70±2.14)h,(68.74±11.02)h,and(7.60±1.29)d],with statistical differences(t=18.855,19.326,19.579,and 16.629;all P<0.001).The intraoperative blood loss was(30.53±5.69)ml in the microsurgery group,and was(49.17±8.50)ml in the traditional surgery group,with a statistical difference(t=11.038,P<0.05).The total effective rate and the incidence of postoperative complications were 97.30%(36/37)and 8.11%(3/37)in the microsurgery group,and were 77.78%(28/36)and 27.78%(10/36)in the traditional surgery group,with statistical differences(χ^(2)

关 键 词：经肛门内镜显微手术 直肠良性肿瘤 胃肠功能恢复 并发症 晚期氧化蛋白产物(AOPP) 谷胱甘肽过氧化物酶(GSH-Px) 

分 类 号：R735.37[医药卫生—肿瘤]