腹腔镜直肠癌根治术对胃肠功能及肛肠动力学的影响

Effect of Laparoscopic Radical Resection of Rectal Cancer on Gastrointestinal Function and Anorectal Dynamics

目的探讨分析腹腔镜直肠癌根治术对胃肠功能及肛肠动力学的影响。方法方便选取该院自2017年1—12月收治的直肠癌患者90例作为研究对象,将之按照随机对照分组的方法分成两组:一组作为观察组(45例),对该组均实施腹腔镜直肠癌根治术治疗;一组作为对照组(45例),对该组均实施传统开腹手术治疗;观察比较两组的胃肠功能情况(包括腹胀持续时间、肛门排气时间、MTL水平、GAS水平)、肛肠动力学指标(包括ARP、MSP、HPZ、RRP)。结果①胃肠功能情况:观察组的腹胀持续时间[(3.15±0.56)d]显著短于对照组[(4.82±0.74)d](t=12.487,P<0.05);肛门排气时间[(2.87±0.42)d]显著早于对照组[(4.05±0.43)d](t=10.869,P<0.05);MTL水平[(225.13±33.26)pg/mL]显著高于对照组[(170.92±21.23)pg/mL](t=9.274,P<0.05);GAS水平[(119.45±12.26)pg/mL]显著高于对照组[(87.63±10.78)pg/mL](t=11.912,P<0.05)。②肛肠动力学指标:观察组在术后1个月和3个月时的ARP[(33.93±9.22)mmHg、(40.74±9.52)mmHg]均显著高于对照组[(30.12±9.05)mmHg、(37.64±8.77)mmHg](P<0.05);MSP [(128.46±20.37)mmHg、(133.51±18.36)mmHg]均显著高于对照组[(110.58±20.14)mmHg、(127.70±16.67)mmHg](P<0.05);HPZ [(2.69±1.41)cm、(3.36±0.75)cm]均显著高于对照组[(2.32±1.26)cm、(2.92±0.96)cm](P<0.05);RRP[(9.71±2.34)mmHg、(7.89±1.92)mmHg]均显著高于对照组[(7.87±2.28)mmHg、(6.86±1.42)mmHg](P<0.05)。结论采用腹腔镜直肠癌根治术治疗直肠癌,能够更有效地促进患者的胃肠功能及肛肠动力学恢复,值得推广。

Objective To investigate the effects of laparoscopic radical rectal cancer on gastrointestinal function and anorectal dynamics. Methods A total of 90 patients with rectal cancer admitted to our hospital from January to December2017 were enrolled in the study. They were divided into two groups according to the randomized method: one group was used as the observation group(45 cases), and the group was implemented laparoscopic radical resection for rectal cancer treatment;one group as the control group(45 cases), the group were treated with traditional laparotomy;the gastrointestinal function of the two groups(including duration of bloating, anal exhaust time, MTL level, GAS level), anorectal dynamics indicators(including ARP, MSP, HPZ, RRP). Results 1.Gastrointestinal function: The duration of bloating in the observation group [(3.15±0.56)d] was significantly shorter than that in the control group [(4.82±0.74)d](t=12.487, P<0.05);anal exhaust time [( 2.87±0.42)d] was significantly earlier than the control group [(4.05 ±0.43)d](t=10.869, P <0.05);the MTL level[(225.13±33.26) pg/mL] was significantly higher than the control group [(170.92±21.23) pg/mL](t=9.274, P<0.05);GAS level[(119.45±12.26) pg/mL] was significantly higher than the control group [(87.63±10.78) pg/mL](t=11.912, P<0.05). 2.Anorectal kinetics index: ARP [(33.93±9.22) mmHg,(40.74±9.52) mmHg] in the observation group at 1 month and 3 months after operation were significantly higher than the control group [(30.12 ±9.05) mmHg,(37.64 ±8.77) mmHg](P <0.05);MSP[(128.46±20.37) mmHg,(133.51±18.36) mmHg] was significantly higher than the control group [(110.58 ±20.14) mmHg,(127.70±16.67) mmHg](P<0.05);HPZ [(2.69±1.41) cm,(3.36±0.75) cm] was significantly higher than the control group[(2.32±1.26) cm,(2.92±0.96) cm](P<0.05);RRP [(9.71±2.34) mmHg,(7.89±1.92) mmHg] were significantly higher than the control group [(7.87±2.28) mmHg,(6.86±1.42) mmHg](P<0.05). Conclusion Laparoscopic radical resection of rectal cancer for rectal cancer can promote the gastrointestinal function and anorectal dynamics of patients more effectively. It is worthy of promotion.