腹腔镜结直肠癌根治术治疗老年结直肠癌患者的效果及对胃肠功能的影响分析  

Analysis of the effect of laparoscopic radical resection of colorectal cancer on elderly patients with colorectal cancer and its influence on gastrointestinal function

作　　者：张文天 ZHANG Wen-tian(Gastroenterology Department,Cangzhou People's Hospital,Cangzhou 061000,China)

机构地区：[1]沧州市人民医院胃肠外科,061000

出　　处：《中国实用医药》2023年第6期10-14,共5页China Practical Medicine

摘　　要：目的 分析腹腔镜结直肠癌根治术治疗老年结直肠癌患者的效果,及对患者胃肠功能的影响。方法 90例老年结直肠癌患者,根据救治方式的不同分为参照组和研究组,每组45例。参照组行常规开腹手术治疗,研究组行腹腔镜结直肠癌根治术治疗。比较两组患者手术开展情况(手术时间、术中出血量、腹腔引流量、术后肛门排气时间、住院时间)、术后并发症(切口感染、吻合口瘘/狭窄、肺部感染)发生率以及术前、术后1周的胃肠功能[一氧化氮(NO)、5-羟色胺(5-HT)、胃泌素(GAS)、乙酰胆碱酯酶(ACh E)]、免疫功能(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))、血清炎症因子[白细胞介素(IL)-4、IL-6、肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)]水平。结果 研究组患者手术时间(158.36±8.36)min、术后肛门排气时间(3.57±0.48)d、住院时间(9.12±2.87)d均短于参照组的(189.36±7.98)min、(5.13±0.54)d、(15.39±3.54)d,术中出血量(140.65±15.21)ml、腹腔引流量(100.36±9.25)ml少于参照组的(210.36±10.69)、(125.36±8.46)ml,差异均具有统计学意义(P<0.05)。术后1周,研究组患者NO(33.25±7.96)μmol/L、5-HT(105.24±10.54)mg/L低于参照组的(46.38±9.21)μmol/L、(168.42±15.12)mg/L,GAS(110.45±9.58)ng/L、ACh E(9.89±0.75)U/L高于参照组的(85.21±10.33)ng/L、(6.24±0.63)U/L,差异均具有统计学意义(P<0.05)。术后1周,研究组患者CD8^(+)(22.13±2.83)%低于参照组的(28.87±3.01)%,CD3^(+)(60.21±4.06)%、CD4^(+)(45.23±3.18)%、CD4^(+)/CD8^(+)(2.14±0.31)均高于参照组的(45.12±3.47)%、(37.27±3.39)%、(1.35±0.28),差异均具有统计学意义(P<0.05)。术后1周,研究组患者IL-4(63.11±3.54)pg/ml、IL-6(13.06±3.13)pg/ml、TNF-α(51.21±3.18)pg/ml、hs-CRP(2.54±1.23)mg/L均低于参照组的(75.23±3.06)pg/ml、(24.69±3.12)pg/ml、(64.23±3.11)pg/ml、(4.05±1.15)mg/L,差异均具有统计学意义(P<0.05)。研究组患者术后并发症发生率6.67%低于参照组的22.Objective To analyze the effect of laparoscopic radical resection of colorectal cancer on elderly patients with colorectal cancer and its influence on gastrointestinal function.Methods A total of 90 elderly patients with colorectal cancer were divided into the reference group and the research group according to the different treatment methods,with 45 cases in each group.The reference group was treated with conventional open surgery,while the research group was treated with laparoscopic radical resection of colorectal cancer.Both groups were compared in terms of surgery(operative time,intraoperative blood loss,abdominal drainage,postoperative anal venting time,hospital stay),incidence of postoperative complications(incisional infection,anastomotic fistula/stenosis,pulmonary infection),and gastrointestinal functions[nitric oxide(NO),5-hydroxytryptamine(5-HT),gastrin(GAS),acetylcholinesterase(AChE),immune function(CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+)),serum inflammatory factors[interleukin(IL)-4,IL-6,tumor necrosis factor-α(TNF-α),high-sensitivity C-reactive protein(hs-CRP)]levels preoperatively and 1 week postoperatively.Results The research group had operative time of(158.36±8.36)min,postoperative anal venting time of(3.57±0.48)d,and hospital stay of(9.12±2.87)d,which were shorter than(189.36±7.98)min,(5.13±0.54)d,and(15.39±3.54)d in the reference group;the intraoperative blood loss(140.65±15.21)ml and abdominal drainage(100.36±9.25)ml in the research group were less than(210.36±10.69)and(125.36±8.46)ml in the reference group;the differences were all statistically significant(P<0.05).At 1 week postoperatively,the NO(33.25±7.96)μmol/L and 5-HT(105.24±10.54)mg/L in the research group were lower than(46.38±9.21)μmol/L and(168.42±15.12)mg/L in the reference group;the GAS(110.45±9.58)ng/L and AChE(9.89±0.75)U/L in the research group were higher than(85.21±10.33)ng/L and(6.24±0.63)U/L in the reference group;the differences were all statistically significant(P<0.05).At 1 week postoperatively,the

关 键 词：腹腔镜结直肠癌根治术 老年结直肠癌 胃肠功能 免疫功能 血清炎症因子 并发症 

分 类 号：R735.34[医药卫生—肿瘤]