全结肠系膜切除术联合术后乌司他丁治疗右半结肠癌的效果及对血清中期因子、肿瘤特异性生长因子水平的影响

Efficacy of Complete Mesocolic Excision Combined with Ulinastatin in Treatment of Right-Side Colon Carcinoma and its Effects on Serum Midkine and Tumor Specific Growth Factor

目的:探讨全结肠系膜切除术联合术后乌司他丁治疗右半结肠癌的效果及对血清中期因子(MK)、肿瘤特异性生长因子(TSGF)水平的影响。方法:选取2015年2月至2018年2月上海交通大学医学院附属新华医院崇明分院收治的右半结肠癌根治术患者120例作为研究对象,按照匹配原则分为对照组和研究组,每组60例。两组患者均进行全结肠系膜切除术,在此基础上,研究组患者术后给予乌司他丁静脉滴注治疗。观察两组患者的治疗效果,治疗前后主要肝肾功能指标[丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、总胆红素(TBIL)、肌酐及尿素氮(BUN)]、MK、TSGF、炎症因子[肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)及白细胞介素8(IL-8)]及免疫功能指标水平和主要并发症发生情况。结果:研究组患者术后进食流质时间、恢复正常饮食时间和住院时间明显短于对照组,差异均有统计学意义(P<0.05)。术后1、3 d,两组患者ALT、AST、TBIL、肌酐和BUN水平均较治疗前明显升高,但研究组患者明显低于对照组,差异均有统计学意义(P<0.05)。治疗后,两组患者血清MK、TSGF、TNF-α、IL-6、IL-8、CD4+及CD8+水平较治疗前明显降低,且研究组患者明显低于对照组,差异均有统计学意义(P<0.05)。研究组、对照组患者的并发症发生率分别为26.67%(16/60)、21.67%(13/60),差异无统计学意义(P>0.05)。结论:全结肠系膜切除术联合术后乌司他丁治疗右半结肠癌的疗效显著,能明显缩短患者的住院时间,改善患者预后,且对术后患者肝肾功能具有一定的保护作用,可显著降低肿瘤相关标志物水平,同时安全性较高。

OBJECTIVE:To probe into the efficacy of complete mesocolic excision(CME)combined with ulinastatin in treatment of right-side colon carcinoma and its effects on serum midkine(MK)and tumor specific growth factor(TSGF).METHODS:120 patients with right-side colon carcinoma admitted into Chongming Hospital of Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine from Feb.2015 to Feb.2018 were selected and divided into control group and research group according to the matching principle,with 60 cases in each group.Both groups were treated with CME,on this basis,the research group was given ulinastatin for intravenous drip after surgery.The clinical efficacy,primary hepatic and renal indices[alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL),creatinine and blood urea nitrogen(BUN)],MK,TSGF,inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and interleukin-8(IL-8)],immunological function indices and incidences of main complications of both groups were observed.RESULTS:The postoperative food-taking time,recovery time of normal diet and hospital stay of research group were significantly shorter than those of the control group,with statistically significant differences(P<0.05).At 1 day and 3 days after surgery,the ALT,AST,TBIL,creatinine and BUN levels of both groups had been significantly increased,and those of research group were significantly lower than the control group,with statistically significant differences(P<0.05).After treatment,the serum MK,TSGF,TNF-α,IL-6,IL-8,CD4+and CD8+levels of both groups had been significantly decreased,and those of research group were significantly lower than the control group,with statistically significant differences(P<0.05).The incidences of complication of research group and control group were respectively 26.67%(16/60)and 21.67%(13/60),the difference had no statistical significance(P>0.05).CONCLUSIONS:The efficacy of CME combined with ulinastatin in treatment of right-side colon carcinoma is remarkable,which can significantly shorten hospital stay and improve patients’prognoses,which has protection for patients’hepatic and renal function,and effectively reduce tumor related marker levels with higher safety.