腹腔镜直肠癌根治术联合预防性回肠造口术Ⅰ期开放治疗对低位直肠癌患者术后恢复的影响

Effect of Laparoscopic Radical Rectal Cancer Combined with Prophylactic Ileostomy StageⅠOpen Treatment on Postoperative Recovery of Patients with Low Rectal Cancer

目的:探讨腹腔镜直肠癌根治术联合预防性回肠造口术Ⅰ期开放治疗对低位直肠癌患者术后恢复的影响。方法:选择2019年3月-2020年4月本院收治的100例低位直肠癌患者为研究对象,按照计算机分组法将其分为对照组(n=50)和观察组(n=50)。对照组给予腹腔镜直肠癌根治术联合预防性回肠造口术Ⅱ期开放治疗,观察组给予腹腔镜直肠癌根治术联合预防性回肠造口术Ⅰ期开放治疗。观察两组术后情况、免疫功能、炎性应激指标水平以及并发症发生情况。结果:术后,观察组发热时间、肠功能恢复时间、住院时间均显著短于对照组,差异均有统计学意义(P<0.05)。术后5 d,对照组IgM、IgA、IgG水平均低于术前,差异均有统计学意义(P<0.05);术后5 d,观察组IgM、IgA、IgG水平均显著高于对照组,差异均有统计学意义(P<0.05)。术后5 d,两组IL-6、CRP、TNF-α水平均高于术前,差异均有统计学意义(P<0.05);观察组IL-6、CRP、TNF-α水平均显著低于对照组,差异均有统计学意义(P<0.05)。观察组并发症发生率为4.00%,显著低于对照组的18.00%,差异有统计学意义(P<0.05)。结论:腹腔镜直肠癌根治术联合预防性回肠造口术Ⅰ期开放不仅对低位直肠癌患者免疫功能影响较小,还可显著改善患者手术情况和免疫功能,下调炎性应激指标水平,且安全性高。

Objective:To explore the effect of laparoscopic radical resection of rectal cancer combined with preventive ileostomy stageⅠopen treatment on postoperative recovery of patients with low rectal cancer.Method:A total of 100 patients with low rectal cancer treated in our hospital from March 2019 to April 2020 were selected as the research objects,and they were divided into control group(n=50)and observation group(n=50)according to computer grouping method.The control group was given laparoscopic radical resection of rectal cancer combined with preventive ileostomy stageⅡopen treatment,and the observation group was given laparoscopic radical resection of rectal cancer combined with preventive ileostomy stageⅠopen treatment.The postoperative condition,immune function,inflammatory stress index level and complications of the two groups were observed.Result:After surgery,the fever time,intestinal function recovery time and hospital stay in the observation group were significantly shorter than those in the control group,the differences were statistically significant(P<0.05).5 d after surgery,the levels of IgM,IgA and IgG in the control group were lower than those before surgery,the differences were statistically significant(P<0.05);5 d after surgery,the levels of IgM,IgA and IgG in the observation group were significantly higher than those in the control group,the differences were statistically significant(P<0.05).5 d after surgery,IL-6,CRP and TNF-αlevels in both groups were higher than those before surgery,the differences were statistically significant(P<0.05);the levels of IL-6,CRP and TNF-αin the observation group were significantly lower than those in the control group,the differences were statistically significant(P<0.05).The incidence of complications in the observation group was 4.00%,significantly lower than 18.00%in the control group,the difference was statistically significant(P<0.05).Conclusion:Laparoscopic radical rectal cancer combined with prophylactic ileostomy stageⅠopen treatment not only has little impact on the immune function of patients with low rectal cancer,but also can significantly improve the surgical situation and immune function of patients,and reduce the level of inflammatory stress indicators,with high safety.