三维重建技术在结直肠癌根治术中的应用效果及对机体免疫、胃肠功能及术后转归的影响

Application effect of three-dimensional reconstruction technique in radical resection of colorectal cancer and its influence on immune function,gastrointestinal function and postoperative outcome

目的:探究三维重建技术在结直肠癌(colorectal cancer,CRC)根治术中的应用效果及对机体免疫、胃肠功能及术后转归的影响。方法:选取2020年01月至2023年04月我院收治的83例CRC患者,均行腹腔镜CRC根治术,将患者随机分为两组,对照组41例术前规划根据多排螺旋CT增强图像实施,观察组42例术前规划根据多层螺旋CT血管三维模型完成术实施。观察两组围术期指标、术后转归情况、术前及术后3 d、7 d胃肠功能、免疫T淋巴细胞(CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+))及并发症情况。结果:观察组手术时间、术后首次排气、进半流食、首次排便及术后住院时间均短于对照组,术中出血量及术后24 h引流量低于对照组(P<0.05);观察组胃动素、胃泌素、胆囊收缩素术后3 d、7 d水平均高于对照组(P<0.05);观察组术后3 d、7 d CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平均高于对照组(P<0.05);观察组并发症发生率较对照组明显降低(P<0.05)。结论:三维重建技术辅助CRC根治术治疗CRC,能优化手术,减轻胃肠功能与免疫功能损伤,促进病情恢复,且可提高安全性。

Objective:To investigate the application effect of three-dimensional reconstruction technology in radical resection of colorectal cancer(CRC)and its influence on immune function,gastrointestinal function and postoperative outcome.Methods:A total of 83 CRC patients admitted to our hospital from January 2020 to April 2023 were selected,all of whom underwent laparoscopic radical CRC surgery.The patients were randomly divided into two groups.The preoperative planning of 41 patients in the control group was performed according to enhanced multi-slice spiral CT images,and the preoperative planning of 42 patients in the observation group was performed according to three-dimensional vascular model of multi-slice spiral CT.Perioperative indexes,postoperative outcomes,gastrointestinal function,immune T lymphocytes(CD3^(+),CD4^(+),CD4^(+)/CD8^(+))and complications of the two groups were observed.Results:The operation time,first postoperative exhaust,semi-liquid feeding,first defecation and postoperative hospitalization time in the observation group were shorter than those in the control group,the amount of intraoperative blood loss and 24 h postoperative drainage volume were lower than those in the control group(P<0.05).The levels of motilin,gastrin and cholecystokinin in observation group were higher than those in control group at 3 and 7 days after operation(P<0.05).The levels of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in the observation group were higher than those in the control group at 3 and 7 days after operation(P<0.05).The incidence of complications in the observation group was significantly lower than that in the control group(P<0.05).Conclusion:Three-dimensional reconstruction technology assisted radical operation for CRC can optimize the operation,reduce the damage of gastrointestinal function and immune function,promote the recovery of the disease,and improve the safety.