腹腔镜根治性切除术治疗膀胱癌及对血清胰岛素样生长因子及其结合蛋白-3的影响  

Laparoscopic radical resection for bladder cancer and its effect on serum insulin-like growth factor and its binding protein-3

作　　者：金艳婷 郭智琴 王珍 JIN Yanting;GUO Zhiqin;WANG Zhen(Department of Urology,Hankou Hospital of Wuhan,Wuhan,Hubei 430012,China)

机构地区：[1]武汉市汉口医院泌尿外科,湖北武汉430012

出　　处：《安徽医药》2022年第11期2261-2265,共5页Anhui Medical and Pharmaceutical Journal

摘　　要：目的研究腹腔镜根治性切除术(LRC)治疗膀胱癌(BC)及对血清胰岛素样生长因子-1(IGF-Ⅰ)及其结合蛋白-3(IGFBP-3)的影响。方法纳入2014年1月至2018年12月于武汉市汉口医院接受治疗的BC病人116例,依据随机数字表法分为LRC组(n=58)与开放根治性切除术(ORC)组(n=58)。ORC组行ORC,LRC组行LRC。观察两组术中出血量、手术时间、术后疼痛评分、肛门排气时间、住院时间等围术期指标,术前及术后3 d血清γ-干扰素、白细胞介素-6等炎性因子,血清IGFBP-3、IGF-Ⅰ等肿瘤因子。术后并发症等。结果LRC组术中出血量、术后疼痛评分、肛门排气时间、住院时间等指标均小于ORC组[(448.97±46.65)mL比(747.68±77.39)mL、(5.15±0.54)分比(7.46±0.76)分、(3.68±0.38)d比(4.48±0.47)d、(17.67±1.92)d比(21.86±2.22)d],手术时间大于ORC组[(318.96±33.44)min比(276.84±29.85)min](P<0.05)。术后3 d,LRC组IL-6水平均低于ORC组[(123.86±13.79)ng/L比(130.86±14.93)ng/L],IFN-γ水平高于ORC组[(15.84±1.75)ng/L比(14.96±1.52)ng/L](P<0.05)。术后3 d,两组IGFBP-3、IGF-Ⅰ水平均差异无统计学意义[(179.75±19.57)mg/L比(182.61±19.62)mg/L、(2.74±0.29)μg/L比(2.70±0.28)μg/L](P>0.05)。LRC组术后并发症发生率(3.45%)低于ORC组(13.79%)(P>0.05)。结论LRC可有效切除BC病灶,改善IGFBP-3、IGF-Ⅰ水平,对机体凝血功能影响小,术后炎症反应轻,疗效与ORC一致,且创伤小,术后并发症发生率低,术后恢复快。Objective To study the effects of laparoscopic radical resection(LRC)on bladder cancer(BC)and serum insulin-like growth factor(IGF-Ⅰ)and its binding protein-3(IGFBP-3).Methods A total of 116 BC patients who were treated in Hankou Hospital of Wuhan from January 2014 to December 2018 were included and divided into the LRC group(n=58)and open radical resection(ORC)group(n=58)according to the random number table method.Patients in the ORC group underwent ORC,and patients in the LRC group underwent LRC.The intraoperative blood loss,operative time,postoperative pain score,anal exhaust time,hospitalization time and other perioperative indicators were observed in the two groups.Serum inflammatory factors,such as interferon-γ(IFN-γ),interleukin 6(IL-6),serum IGFBP-3,IGF-1 and other tumor factors,and postoperative complications before surgery and 3 days after surgery were also observed.Results The intraoperative blood loss,postoperative pain score,anal exhaust time,hospital stay and other indicators in the LRC group were smaller than those in the ORC group[(448.97±46.65)m L vs.(747.68±77.39)m L,(5.15±0.54)vs.(7.46±0.76),(3.68±0.38)d vs.(4.48±0.47)d,(17.67±1.92)d vs.(21.86±2.22)d],and the operation time was longer than that in the ORC group[(318.96±33.44)min vs.(276.84±29.85)min](P<0.05).On the 3rd day after the operation,the level of IL-6 in the LRC group was lower than that in the ORC group[(123.86±13.79)ng/L vs(130.86±14.93)ng/L],and the level of IFN-γwas higher than that in the ORC group[(15.84±1.75)ng/L vs(14.96±1.52)ng/L](P<0.05).On the 3rd day after the operation,there was no significant difference in the levels of IGFBP-3 and IGF-1 between the two groups[(179.75±19.57)mg/L vs.(182.61±19.62)mg/L,(2.74±0.29)μg/L vs.(2.70±0.28)μg/L](P>0.05).The incidence of postoperative complications in the LRC group(3.45%)was lower than that in the ORC group(13.79%)(P<0.05).Conclusion sLRC can effectively remove BC lesions,improve the levels of IGFBP-3 and IGF-1,and have little effect on the body’s coagulat

关 键 词：膀胱肿瘤 膀胱切除术 腹腔镜根治性切除术 胰岛素样生长因子结合蛋白-3 胰岛素样生长因子-1 凝血功能 炎性反应 

分 类 号：R737.14[医药卫生—肿瘤]