腹腔镜与开放性根治术对膀胱癌患者氧化应激指标水平的影响

Effect of Laparoscopic and Open Radical Surgery on the Level of Oxidative Stress in Patients with Bladder Cancer

【目的】比较腹腔镜与开放性根治术对膀胱癌患者机体氧化应激反应的影响。【方法】回顾性分析本院收治的100例膀胱癌患者的临床资料,根据手术方法分为观察组(腹腔镜下膀胱癌根治术)和对照组(开放性根治术),每组各50例。对比两组患者的手术时间、出血量、术后肛门排气时间、住院时间、手术并发症发生率,比较手术前后血清皮质醇(Cor)、活性氧(ROS)、超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)的变化。【结果】观察组手术时间长于对照组,出血量、排气时间、住院时间均低于对照组,差异均有统计学意义(P<0.05)。术后24 h,两组血清Cor、ROS水平均高于术前,血清SOD、GSH-Px水平低于术前,观察组患者血清Cor、ROS水平均低于对照组,血清SOD、GSH-Px水平均高于对照组,差异均有统计学意义(P<0.05)。观察组患者术后并发症发生率为6%(3/50),低于对照组的22.00%(11/50),其差异有统计学意义(χ^2=5.316,P<0.05)。【结论】与开放性根治术比较,腹腔镜下根治术治疗膀胱癌临床疗效较好,对患者机体创伤小,术后恢复快,患者氧化应激反应轻,值得临床推广应用。

【Objective】To compare the effects of laparoscopic and open radical surgery on oxidative stress in patients with bladder cancer.【Methods】The clinical data of 100 cases of bladder cancer in our hospital were analyzed retrospectively.According to the operation methods,the patients were divided into two groups:the observation group(laparoscopic radical surgery)and the control group(open radical surgery),each group had 50 cases.The changes of serum cortisol(Cor),ROS,SOD and GSH PX were compared before and after operation.【Results】The operation time of the observation group was longer than that of the control group,and the bleeding volume,exhaust time and hospitalization time were lower than those of the control group(P<0.05).24 hours after operation,the levels of serum Cor and ROS in the two groups were higher than those before operation,the levels of serum SOD and GSH PX in the observation group were lower than those in the control group,and the levels of serum SOD and GSH PX in the observation group were higher than those in the control group(P<0.05).The incidence of postoperative complications in the observation group was 6%(3/50),lower than 22.00%(11/50)in the control group,and the difference was statistically significant(χ^2=5.316,P<0.05).【Conclusion】Compared with the open radical operation,laparoscopic radical operation has better clinical effect in the treatment of bladder cancer.It has less trauma to patients,faster postoperative recovery,and less oxidative stress response.It is worthy of clinical application.