经肛门直肠镜下微创手术对直肠癌患者疼痛应激、胃肠激素、血管内皮功能的影响

Effect of minimally invasive surgery under anus and colonoscopy on pain stress, gastrointestinal hormones and vascular endothelial function in patients with rectal cancer

目的:探讨经肛门直肠镜下微创手术对直肠癌患者疼痛应激、胃肠激素、血管内皮功能的影响。方法:回顾性分析64例接受经肛门直肠镜下微创外科手术治疗的直肠癌患者的临床资料,纳入观察组;另选取同期行传统开腹手术治疗患者64例,纳入对照组。比较两组患者疼痛应激、胃肠激素、血管内皮功能以及肿瘤标志物变化。结果:术前,两组疼痛应激指标、胃肠激素、血管内皮功能指标以及肿瘤标志物水平比较,差异无统计学意义(P>0.05);术后,两组SP、BK、PGE2水平均较术前升高(P<0.05),GAS、MTL、VIP、VEGF、MMP-9、ET-1、CEA、CA724、CA125、CA19-9水平均较术前降低(P<0.05);其中观察组术后SP、BK、PGE2、VEGF、MMP-9、ET-1、CEA、CA724、CA125、CA19-9水平均低于对照组(P<0.05),GAS、MTL、VIP水平均明显高于对照组(P<0.05)。结论:经肛门直肠镜下微创手术治疗对直肠癌患者的疼痛应激小,患者胃肠激素影响轻微,能更有效降低患者血管内皮功能指标、肿瘤标志物水平,更有助于患者免疫功能恢复,促进患者术后康复。

Objective: To discuss the effects of minimally invasive surgery under transrectal anoscope on pain stress, gastrointestinal hormones and vascular endothelial function in patients with rectal cancer. Methods: Retrospective analysis of clinical data of 64 patients with rectal cancer who underwent minimally invasive surgery under transanal anastomosis from January 2017 to December 2018 in our hospitalto the observation group is conducted. Another 64 patients who underwent traditional laparotomy at the same time in our hospital were selected as the control group.. Pain stress, gastrointestinal hormones, vascular endothelial function, and tumor marker changes were compared between the two groups. Results: There were no significant differences in pain stress index, gastrointestinal hormone, vascular endothelial function index and tumor marker level between the two groups before operation ( P >0.05). After operation, the levels of SP, BK and PGE 2 in the two groups were higher than those before surgery ( P <0.05), and the levels of GAS, MTL, VIP, VEGF, MMP-9, ET-1, CEA, CA724, CA125 and CA19-9 were higher with preoperative reduction ( P <0.05). The levels of SP, BK, PGE 2, VEGF, MMP-9, ET-1, CEA, CA724, CA125 and CA19-9 in the observation group after operation were lower than those in the control group ( P <0.05), and the GAS, MTL and VIP levels were significantly higher than the control group ( P <0.05). Conclusion: Minimally invasive surgery under transanal anoscope can reduce the pain stress of patients with rectal cancer, and the influence of gastrointestinal hormones is slight. It can effectively reduce the vascular endothelial function index and tumor marker level, help the immune function recovery of patients.and promote postoperative rehabilitation of patients.