腹腔镜结直肠癌根治术对血流动力学及及胃肠功能的影响

The effect of laparoscopic colorectal cancer radical surgery onhemodynamics and and gastrointestinal function

目的探讨腹腔镜结直肠癌根治术(LRCC)对血流动力学及及胃肠功能的影响。方法选取我院2010年3月至2014年5月收治的80例结直肠癌患者为研究对象,采用随机数字表法分为对照组和观察组各40例,观察组行LRCC术治疗,对照组采用开腹根治术,比较两组手术情况、血流动力学、胃肠功能及并发症。结果 1手术情况:观察组患者手术时间明显长于对照组(128.26±14.94vs 106.93±11.16)min(P<0.05),术中出血量及术后住院时间明显低于对照组[(89.26±9.18vs 119.48±14.26)mL,(11.16±2.48vs 16.25±2.38)d](P<0.05);2胃肠功能:观察组肛门排气、腹胀持续时间明显短于对照组(3.27±0.59vs 4.98±0.62、2.98±0.47vs 4.11±0.45)d(P<0.05),胃动素、胃泌素水平明显高于对照组(222.52±31.38vs 168.42±20.49、118.25±12.58vs 88.24±10.21)pg/mL(P<0.05);3血流动力学:观察组气腹后30min、60min、120min时点CVP均明显高于对照组(16.21±1.52vs 12.71±1.41、16.92±1.03vs 12.86±1.05、17.89±1.35vs 12.45±1.37)cmH2O(P<0.05);4并发症:观察组并发症发生率明显低于对照组(12.50%vs 35.00%)(P<0.05)。结论腹腔镜结直肠癌根治术有助于减轻手术创伤,促进胃肠功能迅速恢复,减少并发症。虽对患者血流动力学相关指标会产生一定影响,通过加强围手术期循环功能检测和预防措施,可在术后短时间内恢复正常。

Objective To investigate the influence of laparoseopie resection of colorectal cancer（ LRCC）on hemodynamics and gastrointestinal function. Methods 80 cases patients with coloreetal cancer in our hospi- tal from 2010 March-2014 May were selected and randomly divided into the control group （40cases）and the observation group（40cases）, the control group using open radical gastrectomy, the observation group were received LRCC treatment, operation situation, hemodynamic, gastrointestinal function, and compli- cations were compared between two groups. Results ① peration situation： observation group surgery time was significantly longer than the control group （128.26± 14.94 vs 106.93± 11.16）min（ P〈0.05）, intra- operative blood loss, postoperative hospitalization time were significantly lower than the control group [（89.26±9.18 vs 119.48±14.26）ml, （11.16±2.48 vs 16.25±2.38）d].（ P〈0.05）;② Gastrointestinal function： observation group the anus exhaust, abdominal distension duration was significantly shorter than the control group （3.27±0.59 vs 4. 98±0.62, 2.98±0.47 vs 4.11±0.45）d（ P〈0.05）, motilin, gastrin level significantly were higher than the control group （222.52± 31.38 vs 168.42±20.49, 118.25± 12.58 vs 88.24±10.21）pg/ml （ P〈0.05） ; ③Hemodynamic： 30 min, 60 min, 120 min after pneumoperitone- urn, observation group CVP were significantly higher than the control group （ 16. 21±1.52 vs 12.71±1. 41, 16.92±1.03 vs 12.86±1.05, 17.89±1.35 vs 12.45±1.37）cmH20（ P〈0.05） ;④Complications：observation group complications was obviously lower than the control group（12.50% vs 35.00%） （ P〈0. 05）. Conclusion Laparoscopic resection of colorectal cancer help to reduce the surgical trauma, promote gastrointestinal function recovery quickly, reduce the complications. But going to have an impact on hemo- dynamic relevant indicators, through strengthened perioperative circulation function testing and preventive measures, can short period of time back to normal after surgery.