四孔法腹腔镜手术治疗结直肠癌的有效性与安全性分析

Efficacy and Safety of Four Hole Laparoscopy Surgery for Colorectal Cancer

目的探讨与分析四孔法腹腔镜手术治疗结直肠癌的有效性与安全性。方法选择2020年1月—2023年1月在大理白族自治州人民医院择期手术的86例结直肠癌患者作为研究对象,根据随机数表法分为四孔组与传统组,每组43例。传统组给予传统开腹手术治疗,四孔组给予四孔法腹腔镜手术治疗,记录两组的有效性与安全性。结果四孔组的手术时间、术中出血量、术后首次排气时间、术后首次排便时间、术后首次进食时间、术后住院时间均少于传统组,差异有统计学意义(P<0.05)。四孔组术后1 d、术后7 d、术后14 d的视觉模拟疼痛量表(Visual Analog Scales,VAS)评分低于传统组,差异有统计学意义(P<0.05)。四孔组术后14 d的肠梗阻、切口感染、吻合口漏、尿潴留、肺部感染等并发症发生率低于传统组,差异有统计学意义(P<0.05)。两组术后14 d的血清超氧化物歧化酶含量高于术前1 d,血清丙二醛含量低于术前1 d,四孔组术后14 d的血清超氧化物歧化酶、丙二醛含量与传统组相比,差异有统计学意义(P<0.05)。四孔组术后14 d的一般健康状况、精神健康、躯体疼痛、活力指数、情感职能等生活质量评分高于传统组,差异有统计学意义(P<0.05)。结论四孔法腹腔镜手术治疗结直肠癌具有很好的安全性与有效性,能缓解患者的疼痛,促进患者康复,降低并发症发生率,改善氧化应激反应,提高患者的生活质量。

Objective To explore and analyze the efficacy and safety of four hole laparoscopy for colorectal cancer.Methods A total of 86 cases of patients with colorectal cancer who underwent Elective surgery in People's Hospital of Dali Bai Autonomous Prefecture from January 2020 to January 2023 were selected as the study subjects.Accorded to random number table,86 patients were divided into the four hole group(43 cases)and the traditional group(43 cases).The traditional group were treated with traditional open surgery,and the four hole group were treated with four hole Laparoscopy.The effectiveness and safety of the two groups were recorded.Results The surgical time,intraoperative bleeding,postoperativefirst exhaust time,postoperativefirst defecation time,postoperativefirst meal time,and postoperative hospitalization time of the four hole group were significantly shorter than those of the traditional group(P<0.05).The visual analog pain scale(VAS)scores of the four hole group on postoperative day 1,7,and 14 were lower than those of the traditional group,and the difference was statistically significant(P<0.05).The incidence of intestinal obstruction,incision infection,anastomotic leakage,urinary retention,pulmonary infection and other complications 14 days after operation in the four hole group was lower than that in the traditional group,with a statistically significant difference(P<0.05).The serum levels of superoxide dismutase and malondialdehyde in the two groups were higher on the 14th day after surgery than on the 1st day before surgery,and lower on the 1st day before surgery.The serum levels of superoxide dismutase and malondialdehyde in the four well group were statistically significant compared to the traditional group on the 14th day after surgery(P<0.05).The general health status,mental health,physical pain,vitality index,emotional function,and other quality of life scores of the four hole group were higher than those of the traditional group 14 days after surgery,and the difference was statistically significant(P<0.05).Conclusion Four hole laparoscopy for colorectal cancer has good safety and effectiveness,which can alleviate patients'pain,promote patients'rehabilitation,reduce the incidence of complications,improve oxidative stress response,and improve patients'quality of life.