腹腔镜结直肠癌根治术对结直肠癌患者创伤应激指标的影响

Influence of laparoscopic radical resection of colorectal cancer on patients’traumatic stress indexes

目的探究腹腔镜结直肠癌根治术对结直肠癌患者创伤应激指标的影响。方法将78例结直肠癌患者按治疗方式不同分为观察组及对照组,每组39例,对照组患者采用开腹结直肠癌根治术治疗,观察组患者采用腹腔镜结直肠癌根治术治疗,比较两组患者创伤应激指标、免疫功能、炎症反应及并发症发生率。结果术后1天,两组患者皮质醇、肾上腺素、醛固酮水平均较术前上升,但观察组患者皮质醇、肾上腺素、醛固酮水平均低于对照组,差异均有统计学意义(P﹤0.05)。术后1天,两组患者CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平均较术前下降,CD8^(+)水平均较术前上升,但观察组患者CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平均高于对照组,CD8^(+)水平低于对照组,差异均有统计学意义(P﹤0.05)。术后1天,两组患者白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、C反应蛋白(CRP)水平均较术前上升,但观察组患者IL-6、IL-8、CRP水平均低于对照组,差异均有统计学意义(P﹤0.05)。观察组与对照组患者并发症总发生率比较,差异无统计学意义(P﹥0.05)。结论结直肠癌患者采用腹腔镜结直肠癌根治术治疗可明显减轻机体创伤性应激反应,稳定免疫功能,减轻机体炎症反应,具有较高安全性,值得进一步推广。

Objective To investigate the effect of laparoscopic radical resection of colorectal cancer on trauma stress indicators in relevant patients.Method A total of 78 colorectal cancer patients were divided into observation group and control group according to different treatment methods,with 39 cases in each group.The control group was treated with open radical colorectal resection,and the observation group was treated with laparoscopic radical colorectal resection.The traumatic stress response,immune function,inflammatory response and the incidence of complications were compared between the two groups.Result One day after the operation,the levels of cortisol,epinephrine and aldosterone in the two groups were increased compared with themselves before the operation,but the levels of cortisol,epinephrine and aldosterone in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).One day after the operation,the levels of CD3^(+),CD4^(+),CD4^(+)/CD8^(+)in the two groups were lower than those before the operation,and the levels of CD8^(+)were increased compared with themselves before the operation.However,the levels of CD3^(+),CD4^(+),CD4^(+)/CD8^(+)in the observation group were higher than those in the control group,and the level of CD8^(+)lower than the control group,the differences were statistically significant(P<0.05).One day after the operation,the levels of interleukin-6(IL-6),interleukin-8(IL-8),and C-reactive protein(CRP)in the two groups were up-regulation compared with those before operation,and the levels of IL-6,IL-8,and CRP in the observation group were lower than the control group,the differences were statistically significant(P<0.05).There was no significant difference in the total incidence of complications between the observation group and the control group(P>0.05).Conclusion Laparoscopic colorectal resection for colorectal cancer patients can significantly reduce the body’s traumatic stress response.This surgical method reduces the body’s inflammatory response by stabilizing immune function,so it has high safety and is worthy of further promotion.