腹腔镜下经自然腔道取标本手术治疗结直肠癌的效果及对术后疼痛和血清GAS、血浆MTL水平的影响  

Effect of laparoscopic natural orifice specimen extraction surgery on colorectal cancer and its influence on postoperative pain and levels of serum GAS and plasma MTL

作　　者：卢先枝 李智 刘英俊 Lu Xianzhi;Li Zhi;Liu Yingjun(Department of General Surgery,Zhengzhou University Affiliated Cancer Hospital,Henan Provincial Cancer Hospital,Zhengzhou 450000,China)

机构地区：[1]郑州大学附属肿瘤医院河南省肿瘤医院普外科,郑州450000

出　　处：《临床医学》2023年第7期1-4,共4页Clinical Medicine

基　　金：河南省卫生健康委员会科技攻关项目(232102311077)。

摘　　要：目的 探讨腹腔镜下经自然腔道取标本手术(NOSES)治疗结直肠癌的效果及对术后疼痛和血清促胃液素(GAS)、血浆胃动素(MTL)水平的影响。方法 根据手术方式将2021年1月至2022年12月在河南省肿瘤医院行手术治疗的82例结直肠癌患者分为对照组与研究组,每组41例。对照组行常规腹腔镜小切口手术治疗,研究组行腹腔镜下NOSES治疗,分析两组手术效果、术后疼痛情况、手术前后血清GAS、血浆MTL水平。结果 两组拔出引流管时间、清扫淋巴数比较,差异未见统计学意义(P>0.05),研究组手术时间长于对照组,术中出血量少于对照组,术后首次排气时间、首次排便时间、首次进食时间、首次下床活动时间均短于对照组,疼痛视觉模拟评分法评分、止痛药物额外使用率均低于对照组,镇痛泵使用时间短于对照组,两组比较差异均有统计学意义(P均<0.05);术前两组血清GAS、血浆MTL水平比较,差异未见统计学意义(P>0.05),术后1周研究组血清GAS、血浆MTL水平均高于对照组,差异有统计学意义(P<0.05)。结论 结直肠癌患者行腹腔镜下NOSES治疗,可有效缩短术后恢复时间,减轻术后疼痛,促进胃肠动力恢复,手术效果较好。Objective To investigate the effect of laparoscopic natural orifice specimen extraction surgery(NOSES)on colorectal cancer and its impact on postoperative pain and levels of serum gastrin(GAS)and plasma motilin(MTL).Methods Eighty-two colorectal cancer patients who underwent surgical treatment at Henan Cancer Hospital from January 2021 to December 2022 were divided into control group and study group,with 41 patients in each group.The control group received conventional laparoscopic small incision surgery,while the study group received laparoscopic NOSES.The surgical effects,postoperative pain,levels of serum GAS and plasma MTL in the two groups were compared.Results There was no significant difference in the extraction time of the drainage tube and the number of lymph nodes cleaned between the two groups(P>0.05).The study group had longer surgical time,less intraoperative bleeding,shorter postoperative first exhaust time,first defecate time,first meal time,and first time out of bed than the control group(P<0.05).The pain visual simulation score and additional use rate of painkillers of the study group were lower than those of the control group(P<0.05).The use time of the analgesic pump was shorter than that of the control group(P<0.05).There was no significant difference in serum GAS and plasma MTL levels between the two groups before surgery(P>0.05).One week after surgery,the levles of serum GAS and plasma MTL the study group were higher than those in the control group(P<0.05).Conclusions Laparoscopic NOSES for colorectal cancer patients can effectively shorten postoperative recovery time,reduce postoperative pain,promote gastrointestinal motility recovery,and achieve good surgical results.

关 键 词：腹腔镜 经自然腔道取标本手术 结直肠癌 效果 术后疼痛 促胃液素 胃动素 

分 类 号：R735.34[医药卫生—肿瘤]