腹腔镜全结肠系膜切除术治疗结肠癌的疗效观察

Efficacy of laparoscopic complete mesocolic excision for colon cancer

目的探讨腹腔镜全结肠系膜切除术(CME)治疗结肠癌患者的临床疗效。方法选取2019年3月至2020年3月间安康市中心医院收治的100例结肠癌患者,采用随机数表法分为研究组和对照组,每组50例。研究组患者采用腹腔镜CME治疗,对照组患者采用开放性结肠系膜切除术治疗,比较两组患者术前及术后24h的血清皮质醇(Cor)、活性氧(ROS)、超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)、血清C反应蛋白(CRP)、可溶性白细胞介素-2受体(s IL-2R)、白细胞介素-8(IL-8)、血管内皮生长因子(VEGF)和多效蛋白(PTN)。结果术前,两组患者血清Cor、Ros、SOD和GSH-Px水平比较,差异无统计学意义(P>0.05)。术后24h,两组患者血清Cor和Ros水平大于术前,血清SOD和GSH-Px水平小于术前,差异均有统计学意义(均P<0.05)。术后24h,研究组患者血清Cor和Ros水平小于对照组,SOD和GSH-Px水平大于对照组,差异均有统计学意义(均P<0.05)。术前,两组患者血清CRP、s IL-2R、IL-8、VEGF和PTN水平比较,差异无统计学意义(P>0.05)。术后24h,研究组患者血清CRP、s IL-2R、IL-8、VEGF和PTN水平均小于对照组,差异均有统计学意义(均P<0.05)。结论腹腔镜CME治疗结肠癌,可增强患者应激指标,降低血清CRP、s IL-2R、IL-8、VEGF和PTN水平,提高治疗效果。

Objective To explore the efficacy of laparoscopic complete mesocolic excision for the treatment of colon cancer.Methods One hundred patients with colon cancer were prospectively selected at Ankang Central Hospital from March 2019 to March 2020.Using random number table method,they were divided into an experimental group and a control group with 50 patients in each group.The experimental group underwent laparoscopic complete mesocolic excision and the control group underwent open mesocolic excisionmesocolic excision.Serum cortisol(Cor),reactive oxygen species(ROS),superoxide dismutase(SOD),glutathione peroxidase(GSH-Px),C-reactive protein(CRP),soluble interleukin-2 receptor(s IL-2 R),interleukin-8(IL-8),vascular endothelial growth factor(VEGF)and polyprotein(PTN)were compared before the operation and 24 h and after the operation.Results There was no significant difference in Cor,ROS,SOD and GSH-Px between the two groups before the operation(P>0.05).At 24 h and after the operation,Cor and ROS levels were higher than those before the the operation and SOD and GSHPx levels were lower than those before the operation(all P<0.05).Moreover,Cor and ROS levels were lower in the experimental group than in the control group and SOD and GSH-Px levels were higher in the experimental group than in the control group(all P<0.05).There was no significant difference in CRP,s IL-2 R,IL-8,VEGF and PTN levels between the two groups before the operation(P>0.05).At 24 h and after the operation,these levels were lower in the experimental group than in the control group(all P<0.05).Conclusion Laparoscopic complete mesocolic excision can enhance stress index,reduce serum CRP,s IL-2 R,IL-8,VEGF and PTN levels and improve therapeutic effect in patients with colon cancer.