| 吴 可,喻亚群,莫丽平,蒋荣刚,陈 博,陆 明.单切口腹腔镜在结直肠手术中的应用效果及对炎症因子与应激反应的影响[J].,2020,(14):2754-2757 |
| 单切口腹腔镜在结直肠手术中的应用效果及对炎症因子与应激反应的影响 |
| Efficacy of Single Incision Laparoscopy in the Treatment of Colorectal Surgery and Its Influence on Inflammatory Factors and Stress Response |
| 投稿时间：2020-02-28 修订日期：2020-03-23 |
| DOI：10.13241/j.cnki.pmb.2020.14.034 |
| 中文关键词: 结直肠癌 腹腔镜结直肠癌根治术 单切口 炎症因子 应激反应 |
| 英文关键词: Colorectal cancer Laparoscopic radical resection of colorectal cancer Single incision Inflammatory factors Stress response |
| 基金项目:广西壮族自治区自然科学基金项目（201511C24136） |
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| 中文摘要: |
| 摘要 目的：探讨单切口腹腔镜在结直肠手术中的应用效果及对炎症因子与应激反应的影响。方法：选择2018年1月至2019年10月我院接诊的98例结直肠癌患者，通过随机数表法分为2组，每组49例。观察组使用单切口腹腔镜结直肠癌根治术，对照组使用传统腹腔镜结直肠癌根治术，常规5孔操作法。比较两组围术期相关情况、手术前后血清炎症因子水平的变化、手术后应激反应及并发症的发生情况。结果：两组淋巴结清扫个数、中转开腹例数、术后排气时间比较差异均无统计学意义(P＞0.05)，观察组手术时间明显长于对照组，脐切口长度、住院时间、术中出血量均显著短于或低于对照组；两组术后1 d、3 d、5 d时高敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、去甲肾上腺素(NE)、肾上腺素(E)、皮质醇(Cor)水平均明显高于术前(P＜0.05)；且观察组术后1d、3d、5d时hs-CRP、TNF-α、IL-6、NE、E、Cor较对照组显著降低(P＜0.05)；两组吻合口瘘、吻合口狭窄、吻合口出血、小肠穿孔、肠梗阻、感染的总发生率比较差异无统计学意义(P＞0.05)。结论：和传统5孔操作法相比，单切口腹腔镜结直肠癌根治术治疗结直肠癌患者的手术时间更长，但术后炎症因子表达更低，应激反应更小，有利于患者术后恢复。 |
| 英文摘要: |
| ABSTRACT Objective: To study the efficacy of single incision laparoscopy in the treatment of colorectal surgery and its influence on the inflammatory factors and stress response. Methods: 98 patients of colorectal cancer who were treated from January 2018 to October 2019 in our hospital were selected, and divided into the observation group and the control group according to the random number table, with 49 cases in each group. The observation group was given single incision laparoscopic colorectal cancer radical operation, the control group was treated by traditional laparoscopic colorectal cancer radical operation, conventional 5-hole operation. The perioperative condition, changes of serum inflammatory factors levels before and after operation, stress response after operation and the occurrence of complications were compared between the two groups. Results: There was all no significant difference in the number of lymphadenectomy, conversion to laparotomy and postoperative exhaust time between the two groups (P＞0.05); the operation time of observation group was significantly longer than that of the control group, the length of umbilical incision, length of stay and intraoperative hemorrhage were shorter or lower than those of the control group; the high sensitive C-reactive protein (hs CRP), tumor necrosis factor-α(TNF-α), interleukin-6 (IL-6), norepinephrine (NE), epinephrine (E) and cortisol (Cor) in the two groups on postoperative 1st, 3rd and 5th day were significantly higher than those before operation (P＜0.05); and the levels of hs-CRP, TNF-α, IL-6, NE, E and cor on postoperative 1st, 3rd and 5th day in the observation group were significantly decreased compared with the control group (P＜0.05); there was no significant difference in the total incidence of anastomotic leakage, anastomotic stenosis, anastomotic bleeding, intestinal perforation, intestinal obstruction and infection between the two groups(P＞0.05). Conclusion: Compared with the traditional 5-hole operation, the single incision laparoscopic radical surgery has longer operation time for colorectal cancer patients, which can relieve inflammatory responses and stress response and is beneficial to the recovery of patients. |
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