腹腔镜手术与开腹手术在老年右半结肠癌治疗中的效果及安全性  

Effectiveness and Safety of Laparoscopic Surgery and Open Surgery in the Treatment of Elderly Right Colon Cancer

作　　者：周圣赢 李卫平[1] 孔智渊 王兵 ZHOU Shengying;LI Weiping;KONG Zhiyuan;WANG Bing(Department of Gastroenterology,Taicang Hospital Affiliated to Soochow University(Taicang First People's Hospital),Suzhou,Jiangsu,215400,China)

机构地区：[1]苏州大学附属太仓医院(太仓市第一人民医院)胃肠外科,江苏苏州215400

出　　处：《中外医疗》2025年第5期14-19,共6页China & Foreign Medical Treatment

摘　　要：目的分析老年右半结肠癌治疗中选择腹腔镜与开腹手术的价值。方法随机选取2022年1月—2024年3月苏州大学附属太仓医院(太仓市第一人民医院)收治的90例老年右半结肠癌患者为研究对象,根据治疗方案差异分为对照组(25例)、观察组(65例)。对照组实施开腹手术治疗,观察组实施腹腔镜手术治疗。比较两组临床疗效、手术及恢复情况、并发症发生情况、肿瘤标志物水平、炎症因子水平、应激反应。结果对照组治疗有效率为80.00%(20/25),低于观察组的96.92%(63/65),差异有统计学意义(χ^(2)=5.043,P<0.05)。观察组手术时间、肛门首次排气时间、住院时间均短于对照组,术中失血量低于对照组,切口长度短于对照组,并发症发生率低于对照组,差异均有统计学意义(P均<0.05)。术后,两组肿瘤标志物水平低于术前,炎症因子与应激水平高于术前,观察组肿瘤标记物、炎症因子与应激反应均低于对照组,差异均有统计学意义(P均<0.05)。结论老年右半结肠癌治疗中选择腹腔镜手术可减轻机体应激反应,通过降低并发症发生率,提高病情控制效果,避免患者长时间住院。Objective To analyze the value of laparoscopic and open surgery in the treatment of right colon cancer in the elderly.Methods A total of 90 elderly patients with right colon cancer admitted to Taicang Hospital Affiliated to Soochow University(Taicang First People's Hospital)from January 2022 to March 2024 were randomly selected as the research objects.According to different treatment schemes,they were divided into control group(25 cases)and observation group(65 cases).The control group was treated with open surgery,and the observation group was treated with laparoscopic surgery.The clinical efficacy,operation and recovery,complications,tumor marker levels,inflammatory factor levels,and stress response were compared between the two groups.Results The total effective rate of clinical treatment in the control group was 80.00%(20/25),which was lower than 96.92%(63/65)in the observation group,and the difference was statistically significant(χ^(2)=5.043,P<0.05).The operation time,the time to the first anal exhaust,and the length of hospital stay in the observation group were all shorter than those in the control group.The intraoperative blood loss in the observation group was lower than that in the control group,the incision length was shorter than that in the control group,and the incidence of complications was lower than that in the control group,and the differences were statistically significant(all P<0.05).After the operation,the levels of tumor markers in both groups were lower than those before the operation,while the levels of inflammatory factors and stress were higher than those before the operation,the levels of tumor markers,inflammatory factors and the stress response in the observation group were all lower than those in the control group,and the differences were statistically significant(all P<0.05).Conclusion Laparoscopic surgery in the treatment of elderly patients with right colon cancer can reduce the body's stress response,reduce the incidence of complications,improve the effect of disease control,av

关 键 词：腹腔镜手术 开腹手术 老年 右半结肠癌 安全性 应激反应 

分 类 号：R6[医药卫生—外科学]