后腹腔镜肾癌根治术治疗T2期肾细胞癌对患者血清CRP、ESR、TNF-α及IL-6影响情况研究

Effect of Retroperitoneal Laparoscopic Nephrectomy on Serum CRP,ESR,TNF-α and IL-6 in Patients with Stage T2 Renal Cell Carcinoma

目的探讨T2期肾癌患者采用后腹腔镜根治术治疗的临床效果及对患者术后血清C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、血沉(ESR)、白细胞介素-6(IL-6)水平的影响。方法选取我院手术治疗的112例T2期肾癌患者(2013年1月至2017年1月)进行回顾性分析,其中56例患者采用后腹腔镜根治术治疗(腹腔镜组)、56例患者采用传统开腹手术(开腹组),对比两种手术方法的围手术期指标、术后血常规及炎性指标。结果腹腔镜组患者的手术时间长于开腹组患者,出血量、术后下床活动时间、术后拔管时间、术后进食时间、住院时间均短于开腹组患者,差异均有统计学意义(P<0.05);术后24h、72h,腹腔镜组患者血清IL-6、TNF-α、CRP、ESR水平均低于同一时间点的开腹组患者,差异有统计学意义(P<0.05);术后24h、72h,腹腔镜组患者WBC水平均低于同一时间点的开腹组患者,Hb、白蛋白高于同一时间点的开腹组患者,差异有统计学意义(P<0.05);腹腔镜组患者的手术并发症率3.57%低于开腹组患者的12.50%,差异有统计学意义(P<0.05)。结论 T2期肾癌患者采用后腹腔镜根治术治疗具有手术创伤小、术后恢复快、患者的炎症反应程度低、并发症更少的优势。

Objective To investigate the clinical effect of retroperitoneal laparoscopic nephrectomy and its effect on serum C reactive protein （ CRP）, tumor necrosis factor-α （ TNF-α ）, erythrocyte sedimentation rate （ ESR ） and interleukin-6 （ IL-6 ） after operation in patients with stage T2 renal cell carcinoma. Methods A total of 112 cases of T2 stage renal cell carcinoma patients treated by operation in our hospital（ from January 2013 to January 2017 ）were analyzed retrospectively, including 56 cases of patients with retroperitoneal laparoscopie nephrectomy（ laparoscopic group ）, 56 cases of traditional laparotomy （ laparotomy group ）. Perioperative index, postoperative blood routine and inflammatory index were compared between the two methods of operation. Results Operation time of laparoseopic group were longer than that of laparotomy group, bleeding volume, postoperative ambulation time,postoperative extubation time,postoperative eating time and hospitalization time were shorter than those of laparotomy group, the differences were statistically significant（ P 〈 0. 05 ） ;24h and 72h after operation, the serum IL-6, TNF-α, CRP and ESR levels of patients in laparoscopic group were lower than those at the same time in laparotomy group, the difference was statistically significant（P 〈0. 05） ;24h and 72h after operation, WBC levels of patients in the laparoscopic group were lower than that at the same time in laparotomy group patients, Hb and albumin level were higher than those at the same time in laparotomy group of patients, the difference was statistically significant（ P 〈 0.05 ） ;the surgical complication rate of laparoscopie group was 3.57%, which was lower than the laparotomy group 12. 50% ,the difference was statistically significant（ P 〈 0. 05 ）. Conclusion Retroperitoneal laparoscopie nephrectomy has advantages of less operative trauma, faster postoperative recovery,lower inflammatory reaction and fewer complieationsfor patients with stage T2 renal cell carcinoma.