直肠癌患者腹腔镜及开腹根治术后感染比较

Postoperative infections in rectal cancer patients undergoing laparoscopic surgery and open radical resection

目的 探究腹腔镜与开腹根治术对直肠癌患者术后感染率及碱性成纤维因子(basic Fibroblast Growth Factor, bFGF)、白细胞介素-10(Interleukin,IL-10)和C-反应蛋白(C-reactive protein,CRP)的影响.方法 选取2018年3月-2019年6月于衡水市人民医院肿瘤科就诊的200例直肠癌患者为研究对象,其中开腹组(80例)、腹腔镜组(120例).统计并比较两组患者围手术期指标、术后并发症和感染发生情况,观察患者bFGF、IL-10及CRP水平变化.结果 腹腔镜组手术时间、术后排气时间、导管留置时间以及术后住院时间较开腹组均显著缩短,术中出血量显著少于开腹组(P<0.05);腹腔镜组患者医院感染总发生率为5.83%,显著低于开腹组的发生率17.50%(x2=6.952,P=0.008);术后不同时间点,腹腔镜组bFGF和CRP水平均低于开腹组,IL-10水平均高于开腹组(P<0.05);腹腔镜组术后并发症发生率为11.67%(14/120),低于开腹组的22.50%(18/80)(x2=4.191,P=0.041).结论 腹腔镜根治术术后直肠癌患者感染率较低,可有效减少手术应激性创伤,并改善相关的血清学指标,值得临床推广.

OBJECTIVE To explore the influence of laparoscopic surgery and open radical resection on incidence of postoperative infection and basic fibroblast growth factor(bFGF),interleukin-10(IL-10)and C-reactive protein(CRP)of the patients with rectal cancer.METHODS Totally 200 patients with rectal cancer who were treated in oncology department of Hengshui People′s Hospital from Mar 2018 to Jun 2019 were enrolled in the study and divided into the open abdominal group with 80 cases and the laparoscopic group with 120 cases.The perioperative indexes and incidence rates of postoperative complications and infection were statistically analyzed and compared between the two groups of patients,and the levels of bFGF,IL-10 and CRP were observed.RESUTLS The operation duration,postoperative exhaust time,catheter indwelling time and postoperative length of hospital stay were significantly shorter in the laparoscopic group than in the open abdominal group,and the intraoperative blood loss volume of the laparoscopic group was significantly less than that of the open abdominal group(P<0.05).The total incidence of nosocomial infection of the laparoscopic group was 5.83%,significantly lower than 17.50%of the open abdominal group(χ~2=6.952,P=0.008).The levels of bFGF and CRP of the laparoscopic group were significantly lower than those of the open abdominal group,and the IL-10 level of the laparoscopic group was significantly higher than that of the open abdominal group(P<0.05).The incidence of postoperative complications of the laparoscopic group was 11.67%(14/120),significantly lower than 22.50%(18/80)of the open abdominal group(χ~2=4.191,P=0.041).CONCLUSION The incidence of postoperative infection is relatively low in the patients undergoing the laparoscopic surgery,it can effectively reduce the incidence of surgical stress trauma,improve related serological indexes,and is worthy to be promoted in the hospital.