腹腔镜结直肠癌根治术对老年患者血清炎症细胞因子的影响

Effect of laparoscopic radical operation on inflammatory cytokines in elderly patients with colorectal cancer

目的探讨腹腔镜直肠癌手术对老年患者血清炎症细胞因子(IL-6、IL-8)的影响。方法 60例患者根据手术方式分为腹腔镜直肠癌根治术(腹腔镜组)和开腹直肠癌根治术(开腹组),术前1 d和术后2 h、1、3、5 d采用酶联免疫吸附双抗体夹心(ELISA)法测定血清中IL-6、IL-8浓度。观察手术时间、术中出血量和术后肠动力恢复等情况。结果术前1 d两组血清IL-6和IL-8水平比较差异无显著性(t=0.023,P=0.491>0.05;t=0.104,P=0.459>0.05)。术后2 h、术后1、3、5 d开腹组血清IL-6、IL-8水平显著高于腹腔镜组,相比较差异有显著性(t=9.734、8.932、8.827、9.395,P<0.01;t=7.317、10.358、2.881、15.05,P<0.01)。腹腔镜组手术时间、术中出血量和术后肠道功能恢复时间均显著低于开腹组,相比较差异有显著性(t=2.644、7.305、7.809,P<0.01)。结论腹腔镜直肠癌根治术对机体干扰小,术后恢复快,是治疗老年结直肠癌患者的一种安全可行的手术方式。

Objective To investigate the effects of laparoscopic radical operation on inflammatory cytokines in elderly patients with color- ectal cancer. Methods 60 cases of patients with colorectal cancer were assigned into laparoscopic radical operation （ laparoscope group） and conventional open radical operation（laparotomy group）. The serum inflammatory cytokines（ IL-6 and IL-8 ）levels were detected by ELISA at preoperative 1 day and postoperative 2 h, 1 day,3 days and 5 days. The operation time, blood loss and postoperative gastrointes- tinal motility recovery time were observed. Results In the preoperative 1 d,the serum IL-6 and IL-8 levels of the two groups showed no significant difference（t =0. 023 ,P =0. 491 〉0. 05 ;t =0. 104,P =0.459 〉0.05）. In the postoperative 2h,1 day,3 days and 5 days,the serum IL-6 and IL-8 levels of laparotomy group were significantly higher than those of the laparoscope group with significant difference（ t = 9. 734,8. 932,8. 827,9. 395, P 〈 0. 01 ; t = 7.317,10. 358,2.881,15.05, P 〈 0.01 ）. The operation time, blood loss and postoperative gastrointestinal motility recovery time of the laparoscope group were significantly lower than the laparotomy group with significant differ- ence （ t = 2. 644,7. 305,7. 809, P 〈 0.01 ）. Conclusion The laparoscopic radical operation on the body with colorectal cancer has fewer interference, rapid postoperative recovery. The laparoscopic radical operation is a safe and feasible surgical approach for treating the elder- ly patients with colorectal cancer.