腹壁悬吊腹腔镜手术治疗结肠癌的效果研究

Study on the effect of abdominal wall suspension laparoscopic surgery in the treatment of colon cancer

目的 探讨腹壁悬吊腹腔镜手术(Abdominal wall suspension laparoscopic surgery, AWSLS)治疗结肠癌的效果。方法 选择本院2016年1月至2020年1月结肠癌患者92例,随机分为AWSLS组和GLS组各46例。GLS组采用气腹腹腔镜手术(Gas laparoscopic surgery, GLS)治疗,AWSLS组采用AWSLS治疗,比较两组围术期指标、体征、血气指标、免疫功能及并发症情况。结果 与GLS组比较,AWSLS组手术时间、肛门排气时间、住院天数短,术中出血量少(P<0.05);术后30min与GLS组比较,AWSLS组心率(HR)、平均动脉压(MAP)水平低,气道峰压(PIP)水平高,动脉血CO分压(PaCO)水平低(P<0.05);术后7d AWSLS组T淋巴细胞CD3^(+)、CD4^(+)较GLS组高(P<0.05);AWSLS组心律失常发生率较GLS组低(P<0.05)。结论 AWSLS治疗结肠癌能缩短手术操作时长,减少出血风险,降低对患者体征、血气指标和免疫功能的影响,避免发生心律失常,加快恢复、缩短住院时间。

Objective To study the effect of abdominal wall suspension laparoscopic surgery(AWSLS) in the treatment of colon cancer. Methods A total of 92 colon cancer patients in our hospital from January 2016 to January 2020 were selected, and the patients were randomly divided into the AWSLS group and the GLS group, with 46 cases in each group. The GLS group was treated with gas laparoscopic surgery(GLS), AWSLS group was treated with AWSLS. The perioperative indexes, physical signs, blood gas indexes, immune function and complications were compared between the two groups. Results Compared with GLS group, AWSLS group had shorter operation time, anal exhaust time, hospital stay and less intraoperative bleeding(P<0.05). At 30 min after operation, the levels of HR and MAP in AWSLS group were lower than those in GLS group, the level of PIP was higher and the level of PaCOwas lower in AWSLS group(P<0.05). On the 7 th day after operation, T lymphocyte CD3^(+) and CD4^(+)in AWSLS group were higher than those in GLS group(P<0.05). The incidence of arrhythmia in AWSLS group was lower than that in GLS group(P<0.05). Conclusion AWSLS in the treatment of colon cancer can shorten the operation time, reduce the risk of bleeding, reduce the impact on patients′ signs, blood gas indexes and immune function, avoid arrhythmia, accelerate patients′ recovery and shorten hospital stay.