腹腔镜膀胱癌根治术的疗效分析及其对患者血清细胞因子水平、应激反应的影响

Analysis on curative effects of laparoscopic radical surgery for bladder cancer and its effect on serum cytokine level and stress response of patients

目的观察腹腔镜膀胱癌根治术的临床疗效,以及其对患者血清细胞因子水平、应激反应的影响。方法选择本院2018年1月~2019年2月住院治疗的90例膀胱癌患者作为研究对象,根据手术方式不同分为两组,对照组(n=45例)采用开放性膀胱癌根治术治疗,观察组(n=45例)采用腹腔镜膀胱癌根治术治疗,检测两组患者术前及术后3天血清白介素(IL)-6、干扰素-γ(IFN-γ)、P物质(P-substance)、前列腺素E2(PGE2)表达水平,比较两组患者手术时间、术中总出血量、淋巴结清扫情况、住院时间及术后并发症发生率。结果观察组患者手术时间、淋巴结清扫时间及住院时间均短于对照组,且术中总出血量、淋巴结清扫期间出血量均少于对照组,差异有统计学意义(P<0.05),而两组淋巴结清扫数量比较,差异无统计学意义(P>0.05);两组患者治疗前IL-6、IFN-γ等细胞因子和P-substance、PGE2等应激反应相关指标表达水平比较差异无统计学意义(P>0.05),两组治疗后IL-6、P-substance、PGE2表达水平较治疗前均升高,而IFN-γ表达水平降低,差异有统计学意义(P<0.05),且观察组治疗后IL-6、P-substance、PGE2表达水平均低于对照组治疗后,而IFN-γ表达水平高于对照组治疗后,差异有统计学意义(P<0.05)。结论腹腔镜膀胱癌根治术疗效显著,对IL-6、IFN-γ、P-substance、PGE2水平影响较小。

Objective To observe the clinical curative effects of laparoscopic radical surgery for bladder cancer and its effect on serum cytokine level and stress response of patients.Methods 90 patients with bladder cancer who were hospitalized in our hospital from January 2018 to February 2019 were selected as the research objects.According to different operation methods,they were divided into two groups.The control group(n=45 cases)was treated with the open radical treatment for bladder cancer while the observation group(n=45 cases)was given laparoscopic radical surgery for bladder cancer.The expression levels of serum interleukin(IL)-6,interferon-γ(IFN-γ),P-substance and prostaglandin E2(PGE2)of 3 days before and after surgery were detected.The operation time,intraoperative blood loss,lymph node dissection condition,length of hospital stay and postoperative complications of patients in two groups were compared.Results The operation time,lymph node dissection time and hospital stay of observation group were shorter than those of the control group,and the total intraoperative blood loss and the blood loss during lymph node dissection were less than those of the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the number of lymph node dissection between the two groups(P>0.05).There was no statistically significant difference in the expression levels of IL-6,IFN-γ,P-substance,PGE2 and other stress response related indicators between the two groups before treatment(P>0.05).After treatment,the expression levels of IL-6,P-substance and PGE2 of two groups were higher than those before treatment,while the expression level of IFN-γwas decreased,and the difference was statistically significant(P<0.05).After treatment,the expression levels of IL-6,P-substance and PGE2 in the observation group were lower than those in the control group while the expression level of IFN-γwas higher than that in the control group.The difference was statistically significant(P<0.05).Conclusion Laparoscopic radical surgery for bladder cancer has significant curative effects,which has little effects on levels of IL-6,IFN-γ,P-substance and PGE2.