直肠癌腹腔镜根治术经自然腔道取标本对患者术后恢复、胃肠激素、机体体液和细胞免疫的影响  

Optimization of Surgical Treatment Plan for Rectal Cancer Patients and Its Influence on Postoperative Recovery,Gastrointestinal Hormones,Body Fluid and Cellular Immunity

作　　者：娄安华 牛国浩 徐崇娟 LOU Anhua;NIU Guohao;XU Chongjuan(Pingmei Shenma Medical Group General,Pingdingshan,467000)

机构地区：[1]平煤神马医疗集团总医院,467000

出　　处：《实用癌症杂志》2023年第8期1308-1312,共5页The Practical Journal of Cancer

摘　　要：目的 研究直肠癌腹腔镜根治术经自然腔道取标本对患者术后恢复、胃肠激素、机体体液和细胞免疫的影响。方法 选取86例直肠癌患者为试验对象,随机分为2组,其中观察组41例,实施腹腔镜手术经自然腔道取标本,对照组45例实施常规腹腔镜手术治疗。比较2组患者的胃肠道恢复、围术期指标、胃肠激素、机体体液和细胞免疫之间的差异。结果 观察组患者的肠鸣音具体的恢复时间、排气所需要的时间以及开始进食所需的时间较对照组更短(P<0.05);2组患者的切除病灶的长度、手术时间、术中出血量和总的淋巴结清扫量间的对比并无差异(P>0.05)。2组患者治疗结束后补体C3、补体C4、IgA、IgG、IgM均显著升高,且观察组患者的补体C3、补体C4、IgA、IgG、IgM显著高于对照组。2组患者的胃动力素以及胃泌素均发生显著改变,且观察组患者的胃动力素较对照组患者更高,而胃泌素较对照组更低。观察组患者出现肠梗阻、切口感染等总的并发症发生概率较对照组更低。观察组患者的术后首次下床的时间和手术结束后使用止痛药的次数较对照组更低,差异明显(P<0.05)。结论 对直肠癌患者实施腹腔镜手术,并在此手术中经自然腔道进行组织取出优化,可促进患者的术后恢复,显著改善胃肠激素、机体体液和细胞免疫功能。Objective To study laparoscopic radical resection of rectal cancer by taking specimens through the natural lumen and its impact on postoperative recovery,gastrointestinal hormones,body fluids,and cellular immunity of patients.Methods 86 cases of patients with rectal cancer were selected as the research object,in accordance with the principle of random grouping,above patients were randomly divided into 2 groups,the observation group 41 cases,control group 45 cases.41 cases in the observation group underwent laparoscopic surgery to obtain specimens through the natural lumen,while 45 cases in the control group underwent conventional laparoscopic surgery,The differences of gastrointestinal recovery,perioperative indexes,gastrointestinal hormones,body fluid and cellular immunity were compared between 2 groups.Result The exhaust time,specific time of intestinal sound recovery and feeding time in observation group were obvious lower than control group(P<0.05).There were no obvious differences in operative time,length of lesion resection,intraoperative blood loss and total lymph node dissection between the 2 groups(P>0.05).After treatment,complement C3,complement C4,IgA,IgG and IgM in 2 groups were significantly increased,and complement C3,complement C4,IgA,IgG and IgM in observation group were obvious higher than control group;The levels of gastrin and gastrin in 2 groups were obvious changed,and gastrin in the observation group was obvious higher than the control group,and gastrin was obvious lower than the control group.Patients in the observation group had lower probability of total complications such as intestinal obstruction and incision infection than those in the control group.The time to get out of bed for the first time and the number of postoperative analgesic drugs used in the observation group were lower than the control group,with statistical significance(P<0.05).Conclusion Performing laparoscopic surgery on rectal cancer patients and optimizing tissue extraction through natural channels during this surgery

关 键 词：直肠癌 腹腔镜 术后恢复 胃肠激素 免疫功能 

分 类 号：R735.3[医药卫生—肿瘤]