中间入路与侧方入路腹腔手术治疗结直肠癌患者的效果  

Effect of abdominal surgery with intermediate approach and lateral approach in patients with colorectal cancer

作　　者：马超 陈大勇[1] 赵勇[1] Ma Chao;Chen Da-yong;Zhao Yong(Department of General Surgery,Nanyang First People's Hospital,Nanyang 473000,Henan,China)

机构地区：[1]南阳市第一人民医院普外科,河南南阳473000

出　　处：《四川生理科学杂志》2025年第3期578-580,591,共4页

摘　　要：目的:对比中间入路与侧方入路腹腔手术治疗结直肠癌(Colorectal cancer,CRC)患者的效果。方法:选取2020年3月至2023年8月期间本院收治的92例CRC患者作为研究对象,采用随机数字表法分为中间入路组和侧方入路组,每组各46例。分析对比两组的围手术期指标、术后恢复指标、并发症发生率,并在术前、术后1m,以免疫分析法检测癌胚抗原(Carcinoembryonic antigen,CEA)水平,以酶联免疫法检测糖类抗原125(Carbohydrate antigen 125,CA125)、CA19-9水平,在术前、术后3 d采用美国贝克曼公司提供的DxFLEX流式细胞仪检测CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平。结果:相较于侧方入路组,中间入路组的术中失血量显著降低,手术用时显著缩短,淋巴结清扫数目显著提高(P<0.05)。相较于侧方入路组,中间入路组的进食时间、住院时间、肠鸣音恢复时间、肛门排气时间均显著缩短(P<0.05)。术后1m中间入路组的血清CEA、CA125、CA19-9水平相较于侧方入路组均显著降低,术后3 d中间入路组的CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平相较于侧方入路组的降低幅度显著减小,且中间入路组并发症发生率显著低于侧方入路组(P<0.05)。结论:相较于侧方入路腹腔手术,经中间入路治疗CRC患者能降低并发症风险,改善围手术期及术后恢复指标,且对机体免疫功能产生影响更小。Objective:To compare the efficacy of abdominal surgery with intermediate approach and lateral approach in the treatment of Colorectal cancer(CRC)patients.Methods:A total of 92 CRC patients admitted to our hospital from March 2020 to August 2023 were selected as research objects.Patients were divided into the intermediate approach group and the lateral approach group according to random number table method,with 46 cases in each group.The perioperative indicators,postoperative recovery indicators,and complication rates of the two groups were analyzed and compared.The level of Carcinoembryonic antigen(CEA)was detected by immunoassay before and one month after surgery.The levels of Carbohydrate antigen 125(CA125)and CA19-9 were detected by enzyme-linked immunosorbent assay.The levels of CD3^(+),CD4^(+),and CD4^(+)/CD8^(+)were detected using a DxFLEX flow cytometer provided by Beckman Coulter before and 3 days after surgery.Results:Compared with the lateral approach group,the intermediate approach group had significantly less intraoperative blood loss,shorter operation time,and higher number of lymph node dissections(P<0.05).Compared with the lateral approach group,the intermediate approach group had significantly shorter eating time,hospitalization time,bowel sound recovery time,and anal exhaust time(P<0.05).One month after surgery,the levels of serum CEA,CA125,and CA19-9 in intermediate approach group were significantly lower than those in the lateral approach group,the decrease in the levels of CD3^(+),CD4^(+),and CD4^(+)/CD8^(+)in the intermediate approach group was significantly less than that in the lateral approach group 3 days after surgery,the incidence of complications in the intermediate approach group was significantly lower than that in the lateral approach group.(P<0.05).Conclusion:Compared with lateral approach abdominal surgery,intermediate approach can reduce the risk of complications,improve perioperative and postoperative recovery indexes,and have less impact on immune function.

关 键 词：腹腔手术 侧方入路 结直肠癌 中间入路 

分 类 号：R73[医药卫生—肿瘤]