腹腔镜手术治疗结肠癌的效果及对患者肠道微生态、血清CA125、CEA、CA199水平的影响

Effect of Laparoscopic Surgery for Colon Cancer and Its Influence on Intestinal Microecology, Serum CA125, CEA and CA199 Levels

目的:探讨腹腔镜手术治疗结肠癌的效果及对患者肠道微生态、血清糖类抗原125(CA125)、癌胚抗原(CEA)、糖类抗原199(CA199)水平的影响。方法:选取2018年1月-2020年1月佳木斯市肛肠医院收治的结肠癌患者64例为观察对象,按照随机数字表法分为两组,各32例。对照组行开腹手术,观察组行腹腔镜手术治疗。比较两组手术情况、并发症发生情况、肠道微生态、血清CA125、CEA、CA199水平及远期疗效。结果:两组手术时间、远切端长度、近切端长度、距下切缘距离、淋巴结清扫数比较,差异均无统计学意义(P>0.05),观察组术中出血量、术后住院天数均少于对照组(P<0.05)。观察组并发症发生率(18.75%)低于对照组(50.00%)(P<0.05)。术后5 d,两组乳酸杆菌、双歧杆菌均升高,且观察组均高于对照组;术后5 d,两组大肠杆菌、梭菌、柔嫩梭菌均下降,且观察组均低于对照组(P<0.05)。术后5 d,两组血清CA125、CEA、CA199水平均下降(P<0.05),但两组间各指标比较,差异均无统计学意义(P>0.05)。观察组肠梗阻发生率低于对照组(P<0.05),两组局部复发、远处转移、切口种植发生率比较,差异均无统计学意义(P>0.05)。结论:腹腔镜手术对结肠癌的短期根治效果及远期疗效确切,能够减轻肿瘤负荷,对肠道微生态影响小,值得推广。

Objective: To investigate the effect of laparoscopic surgery for colon cancer and its influence on intestinal microecology, serum carbohydrate antigen 125(CA125), carcinoembryonic antigen(CEA) and carbohydrate antigen 199(CA199). Method: A total of 64 patients with colon cancer in Jiamusi Anorectal Hospital from January 2018 to January 2020 were selected as the observation objects and divided into two groups according to the random number table method, with 32 cases in each group. The control group received laparotomy and the observation group received laparoscopic surgery. The operation conditions, complications, intestinal microecology, serum CA125, CEA,CA199 levels and long-term efficacy were compared between the two groups. Result: There were no significant differences in operation time, distal end length, proximal end length, distance from lower cutting edge and number of lymph node dissection between the two groups(P>0.05);the intraoperative bleeding, postoperative hospital stay in the observation group were less than those in the control group(P<0.05). The incidence of complications in the observation group was 18.75%, which was lower than 50.00% in the control group(P<0.05). 5 d after operation, the levels of Lactobacillus and Bifidobacterium in the two groups increased, and those of the observation group were higher than those of the control group;the levels of Escherichia coli, Clostridium and Clostridium tenella in the two groups decreased 5 d after operation, and those of the observation group were lower than those of the control group(P<0.05). The serum levels of CA125, CEA and CA199 in the two groups were decreased 5 d after operation(P<0.05),but there were no significant differences between the two groups(P>0.05). The incidence of intestinal obstruction in the observation group was lower than that in the control group(P<0.05). There were no significant differences in the incidence of local recurrence, distant metastasis and incision implantation between the two groups(P>0.05).Conclusion: The short-term curative effect and long-term curative effect of laparoscopic surgery in the treatment of colon cancer are exact, which can reduce the tumor load and has little impact on intestinal microecology, so it is worthy of promotion.