双镜联合根治术与腹腔镜根治术在早期结肠癌患者中的应用效果  

Application effect of double mirror combined radical operation and laparoscopic radical operation in patients with early colon cancer

作　　者：杜彦斌[1] 黄涛[1] 寇天阔 石英[2] Du Yanbin;Huang Tao;Kou Tiankuo;Shi Ying(Department of General Surgery,Beijing Daxing District People’s Hospital,BeiJing 102600,China;BeiJing YouAn Hospital,Capital Medical University,BeiJing 100069,China)

机构地区：[1]北京市大兴区人民医院普外科,北京102600 [2]首都医科大学附属北京佑安医院,北京100069

出　　处：《中华普外科手术学杂志（电子版）》2024年第3期275-278,共4页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：北京市自然科学基金项目(7182072)。

摘　　要：目的探讨双镜联合根治术与腹腔镜根治术在早期结肠癌患者中的应用效果。方法选取2019年1月至2023年9月期间81例早期结肠癌患者为研究对象,采用随机数字表法将患者分为A组(n=40例)与B组(n=41例)。A组患者行双镜联合根治术(即腹腔镜联合结肠镜根治术),B组患者行腹腔镜根治术。采用SPSS 25.0完成所有的数据分析,术后并发症等计数资料用百分比表示,采用χ^(2)检验;围手术期指标、免疫功能、胃肠功能等计量资料采用(x±s)表示,组间比较用独立样本t检验,组内比较用配对样本t检验。P<0.05为差异有统计学意义。结果相较B组,A组患者手术时间较长,术后排气、下床及住院时间缩短,且出血量更低(P<0.05);相较术前,两组患者术后辅助性T淋巴细胞1(Th1)、Th1/辅助性T淋巴细胞2(Th2)均下降,Th2升高,且B组变化幅度更大(P<0.05);相较术前,两组患者术后胃泌素(GAS)、胃动素(MTL)水平均降低(P<0.05),但术后两组患者指标比较,差异无统计学意义(P>0.05);两组患者并发症发生情况比较,差异无统计学意义(P>0.05)。结论两种内镜根治术对胃肠功能的影响程度及安全性相当。但相较于腹腔镜根治术,双镜联合根治术可降低术中出血量,缩短患者术后康复时间,且对免疫功能的损伤较轻。但双镜联合根治术存在手术时间较长问题。Objective To investigate the effect of double mirror combined radical operation and laparoscopic radical operation in early colon cancer patients.Methods A total of 81 patients with early colon cancer from January 2019 to September 2023 were selected as the study objects,and the patients were divided into group A(n=40 cases)and group B(n=41 cases)by random number table method.Group A was treated with double mirrors combined with radical surgery(i.e.laparoscopic combined with colonoscopy radical surgery),group B was treated with laparoscopic radical surgery.SPSS 25.0 was used to complete all data analysis.The statistical data of postoperative complications were expressed as percentage andχ^(2)test was used.Perioperative indicators,immune function,gastrointestinal function and other measurement data were represented by(x±s).Independent sample t test was used for inter-group comparison and paired sample t test was used for intra-group comparison.P<0.05 was considered statistically significant.Results Compared with group B,the operation time of group A was longer,the postoperative exhaust,getting out of bed and hospitalization time were shorter,and the amount of blood loss was lower(P<0.05).Compared with the preoperative level,helper T lymphocyte 1(Th1)and Th1/helper T lymphocyte 2(Th2)decreased and Th2 increased in both groups after surgery,and the change range was greater in group B(P<0.05).Compared with the preoperative level,the levels of gastrin(GAS)and motilin(MTL)were decreased in both groups after surgery(P<0.05),but there was no statistical significance in the indexes between the two groups after surgery(P>0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion The two kinds of endoscopic radical operation had similar effects on gastrointestinal function and safety.However,compared with laparoscopic radical surgery,double mirror combined radical surgery can reduce the amount of intraoperative blood loss,shorten the postoperative recovery time of

关 键 词：结肠肿瘤 早期诊断 腹腔镜 结肠镜 免疫功能 胃肠功能 

分 类 号：R735.35[医药卫生—肿瘤]