腹腔镜手术治疗结直肠癌患者的近期疗效及对机体应激反应的影响

Short-term efficacy of laparoscopic surgery and its effect on stress response in patients with colorectal cancer

目的 探讨腹腔镜手术治疗结直肠癌患者的近期疗效及对机体应激反应的影响。方法 将168例结直肠癌患者按照随机数字表法分为开放手术组、腹腔镜手术组,每组84例。比较两组患者手术相关指标、胃肠功能指标、炎症指标、应激指标、术后并发症发生情况以及治疗有效率。结果 开放手术组患者手术时间明显短于腹腔镜手术组,术中出血量明显多于腹腔镜手术组,住院时间明显长于腹腔镜手术组,差异均有统计学意义(P﹤0.01)。腹腔镜手术组患者排气时间、排便时间及进食时间均明显短于开放手术组,差异均有统计学意义(P﹤0.01)。手术后,两组患者白细胞(WBC)计数、C反应蛋白(CRP)、白细胞介素-6(IL-6)、中性粒细胞(NE)、皮质醇(Cor)水平均高于本组手术前,但腹腔镜手术组患者WBC计数、CRP、IL-6、NE、Cor水平均低于开放手术组,差异均有统计学意义(P﹤0.05)。腹腔镜手术组患者术后并发症总发生率低于开放手术组,治疗总有效率高于开放手术组,差异均有统计学意义(P﹤0.05)。结论 采用腹腔镜手术、开放手术对结直肠癌患者进行治疗均有着较好的临床效果,但与开放手术相比,腹腔镜手术治疗对机体炎症、应激反应的影响较小,且并发症发生率较低,治疗有效率较高。

Objective To analyze the short-term efficacy of laparoscopic surgery and its effect on stress response in patients with colorectal cancer. Method A total of 168 patients with colorectal cancer were randomly divided into open surgery group(n=84) and laparoscopic surgery group(n=84) by random number table method. The operation related indexes, gastrointestinal function indexes, inflammation indexes, stress indexes, postoperative complications and treatment effective rate of the two groups were compared. Result The operation time was shorter, intraoperative blood loss was more and hospital stay was longer in the open surgery group than those in the laparoscopic surgery group(P<0.01). The exhaust time, defecation time and eating time in the laparoscopic surgery group were shorter than those in the open surgery group(P<0.01). After surgery, the white blood cell(WBC), C-reactive protein(CRP), interleukin-6(IL-6), neutrophil(NE) and cortisol(Cor) in both groups were higher than those before surgery, with lower WBC, CRP, IL-6, NE and Cor in laparoscopic surgery group than those in open surgery group(P<0.05);the total incidence of postoperative complications in the laparoscopic surgery group was lower and total effective rate higher than those in the open surgery group(P<0.05). Conclusion Both laparoscopic surgery and open surgery have good clinical effect in the treatment of colorectal cancer patients, but compared with open surgery, laparoscopic surgery has less impact on the inflammation and stress response with lower complications and higher effective rate.