目的观察腹腔镜根治术治疗直肠癌的创伤应激表现。方法将76例直肠癌患者随机分为观察组和对照组,每组38例。观察组接受腹腔镜直肠癌根治术治疗,对照组接受常规开腹手术治疗。比较两组手术时间、术中出血量、住院时间、术后发热时间、胃肠功能恢复时间、手术前后腋温变化;比较两组患者术前及术后1 d白介素-6(IL-6)、肿瘤坏死因子α(TNF-α)、C反应蛋白(CRP)、生长激素释放多肽(Ghrelin)的变化。结果观察组手术时间明显长于对照组,两组比较,差异有统计学意义(P<0.05);观察组术中出血量、住院时间、发热时间、胃肠功能恢复时间及术后腋温均明显低于对照组,两组比较,差异有统计学意义(P<0.05);两组术后IL-6、TNF-α、CRP、Ghrelin表达上升,与术前比较,差异有统计学意义(P<0.05);术后1 d,观察组IL-6、TNF-α、CRP、Ghrelin水平均显著低于对照组,两组比较,差异有统计学意义(P<0.05);两组并发症发生率比较,差异无统计学意义(P>0.05)。结论腹腔镜手术治疗直肠癌可获得较满意的效果,对患者机体应激的影响较小,并发症发生率低,因此在老年人等特殊群体中有良好的适用性。
ObjectiveTo observe the effect of laparoscopic radical operation on stress response in patients with rectal cancer. MethodsA total of 76 patients with rectal cancer were selected and randomly divided into observation group and control group, 38 in each group. Patients in the observation group were performed laparoscopic radical operation, and the control group were performed traditional open surgery. The operation time, blood loss, postoperative hospital stay, postoperative fever time, intestinal function recovery time and variation of axillary temperature were compared. In addition, interleukin-6 (IL-6), tumor necrosis factor(TNF-α), C-reactive protein(CRP) and Ghrelin before and one day after surgery were compared. ResultsCompared with the control group, the operation time were significantly longer in the observation group(P<0.05). The blood loss, postoperative hospital stay, postoperative fever time, intestinal function recovery time, postoperative axillary temperature in the observation group were significantly lower than those in the control group (P<0.05). Both groups had significantly higher levels of IL-6、TNF-α、CRP and Ghrelin after surgery, there were significant differences between the two groups(P<0.05). The first day after surgery, IL-6, TNF-α, CRP, Ghrelin in the observation group were lower than those in the control group,there were significant differences between the two groups(P<0.05). The incidence of complications were not statistically different between the two groups(P>0.05). ConclusionLaparoscopic radical operation is better than traditional open surgery in patients with rectal cancer, it relieves the stress response and had low rate of complications. It may be the proper choice in the elderly patients with rectal cancer.