[1]高怀军,余 伟.腹腔镜结直肠癌根治术治疗结直肠癌临床疗效及对患者胃肠功能的影响[J].陕西医学杂志,2019,(8):990-993.
 GAO Huaijun,YU Wei..Clinical study of laparoscopic radical resection in the treatment of colorectal cancer in and its influence on gastrointestinal function[J].,2019,(8):990-993.
点击复制

腹腔镜结直肠癌根治术治疗结直肠癌临床疗效及对患者胃肠功能的影响
分享到:

《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
期数:
2019年8期
页码:
990-993
栏目:
临床研究
出版日期:
2019-08-05

文章信息/Info

Title:
Clinical study of laparoscopic radical resection in the treatment of colorectal cancer in and its influence on gastrointestinal function
文章编号:
DOI:10.3969/j.issn.1000-7377.2019.08.008
作者:
高怀军余 伟
陕西省榆林市中医医院普外科(榆林719000)
Author(s):
GAO HuaijunYU Wei.
Yulin Hospital of Traditional Chinese Medicine in Shaanxi Province(Yulin 719000)
关键词:
结直肠癌腹腔镜检查结直肠癌根治术淋巴结清扫数量胃肠功能生活质量
Keywords:
Key words Colorectal cancer LaparoscopyRadical resection of colorectal cancer The number of lymph node dissection Gastrointestinal function Quality of life
分类号:
R735.3
文献标志码:
A
摘要:
摘 要 目的:探讨腹腔镜结直肠癌根治术治疗结直肠癌患者的临床疗效及对胃肠功能的影响。方法:127例结直肠癌患者随机分为观察组(n=46)和对照组(n=63)。对照组给予传统开腹结直肠癌根治术,观察组给予腹腔镜下结直肠癌根治术治疗。观察两组术中出血量、手术时间、住院时间,淋巴结清扫数量,术后并发症发生情况,肠鸣音恢复时间、术后排气时间、进食时间等胃肠功能及SF-36评分。结果:观察组术中出血量及住院时间均低于对照组(t=-13.527, P=0.000; t=-10.931 ,P=0.000),而手术时间高于对照组(t=4.624,P=0.000)。观察组淋巴结清扫数量与对照组比较差异无统计学意义(t=1.948,P=0.000)。观察组肠鸣音恢复时间、术后排气时间、进食时间均低于对照组(t=-13.583,P=0.000; t=-7.884,P=0.000;t=-14.325,P=0.000)。术后,两组SF-36评分与治疗前比较均显著升高(t=8.111,P=0.000; t=6.804,P=0.001);观察组SF-36评分(81.32±21.47)显著高于对照组(74.21±17.89)(t=2.029,P=0.045)。观察组术后并发症发生率4.69%显著低于对照组15.87%(χ2=4.323, P=0.038)。结论:腹腔镜结直肠癌根治术治疗结直肠癌临床疗效显著,可有效减少术中出血量、缩短住院时间、促进胃肠功能恢复、改善患者预后、提高患者生活质量、安全性高。
Abstract:
Abstract Objective: This study aims to investigate the clinical efficacy of laparoscopic radical resection of colorectal cancer and its effect on gastrointestinal function. Methods: 127 patients admitted were randomly divided into observation group (n=46) and control group (n=63). The control group was treated by traditional open radical resection of colorectal cancer, while the observation group was treated by laparoscopic radical resection of colorectal cancer. It observed and compared the volume of intraoperative bleeding, operation time, hospitalization time, the number of lymph node dissection, postoperative complication, recovery time of bowel sounds, postoperative exhaust time, eating time, gastrointestinal function and SF-36 score between the two groups.Results:The volume of intraoperative bleeding and hospitalization time in the observation group were lower than those in the control group (t=-13.527,P=0.000; t=-10.931, P=0.000). While, the operation time in the observation group was higher than that in the control group (t=4.624, P=0.000). There was no significant difference in the number of lymph node dissection between the observation group and the control group (t=1.948,P=0.000). The recovery time of bowel sounds, exhaust time and eating time in the observation group were lower than those in the control group (t=-13.583,P=0.000; t=-7.884, P=0.000; t=-14.325,P=0.000). After operation, the SF-36 score of the two groups were significantly higher than those before treatment (t=8.111,P=0.000; t=6.804,P=0.001). In addition, the SF-36 scores of(81.32±21.47)in the observation group was significantly higher than that of(74.21±17.89)in the control group (t=2.029, P=0.045). The incidence of postoperative complication of 4.69% in the observation group was significantly lower than that of 15.87% in the control group (χ2=4.323, P=0.038). Conclusion:Laparoscopic radical resection of colorectal cancer has a significant clinical effect. It can effectively reduce intraoperative bleeding, shorten hospitalization time, promote the recovery of gastrointestinal function, improve the prognosis of patients, improve the quality of life of patients. It is worthy of promotion and application.〖LM〗

参考文献/References:

[1] 鞠海星, 黄 新, 朱玉萍, 等. 手辅助腹腔镜和腹腔镜及开腹直肠癌根治术的近期疗效比较[J]. 中华胃肠外科杂志, 2014,17(6):574-577.
[2] 宋 斌, 刘 栋, 宋雯茜, 等. 结直肠癌55例术后辅以替吉奥方案化疗临床观察[J]. 陕西医学杂志, 2016,45(11):1507-1509.
[3] 汪 飙. 两种腹腔镜直肠癌根治术和传统开腹手术的对比研究[J]. 中华普外科手术学杂志:电子版,2018,12(1):49-52.
[4] 张兴茂, 周志祥. 结直肠癌根治术淋巴结检出数目的临床意义[J].实用肿瘤杂志, 2014,29(3):209-212.
[5] 宋伟华, 李晓勇, 周百中. 腹腔镜结直肠癌根治术治疗老年结直肠癌患者的疗效及对胃肠功能的影响[J]. 中国老年学杂志, 2014,34(23):6624-6626.
[6] 高 强, 李志周, 陈 锋, 等. 腹腔镜辅助下直肠外翻拖出式手术治疗直肠癌的临床效果研究[J]. 陕西医学杂志, 2015,44(8):968-969.
[7] 曾焕虹, 傅 卫, 孙 涛, 等. 腹腔镜直肠癌根治术后患者的长期生存及其影响因素[J]. 中华普通外科杂志, 2018,33(1):25-29.
[8] 中国临床肿瘤学会(CSCO). 结直肠癌诊疗指南\[Z\]. 2016-12-18. 
[9] 高王军, 李福广. 腹腔镜结直肠癌根治术对结直肠癌患者临床疗效及胃肠功能的影响[J]. 癌症进展, 2016,14(9):910-912.
[10] 谢 锷, 王小忠, 林祥伟, 等. 腹腔镜与开腹直肠癌根治术对血浆血管内皮生长因子水平的影响[J]. 中华胃肠外科杂志, 2013,16(10):989-992.
[11] Tucker SL, Dong L, Michalski JM, et al. Do intermediate radiation doses contribute to late rectal toxicity an analysis of data from radiation therapy oncology group protocol 94-06[J]. Int J Radiat oncol Biol PhysInternational Journal of Radiation Oncology, Biology, Physics, 2012,84(2): 390-395.
[12] 李 东. 腹腔镜直肠癌根治术和开腹手术直肠癌根治术的疗效及对患者胃肠功能影响的比较[J]. 实用癌症杂志, 2016,31(3):455-458.
[13] 任 聪, 白文武, 罗志民,等. 腹腔镜直肠癌根治术中保留左结肠动脉可行性的研究[J]. 河北医学, 2018,24(2):286-290.
[14] 刘国伟, 邱 钢, 张 萍, 等. 术中出血量对直肠癌根治术100例预后的影响分析[J]. 陕西医学杂志, 2012,41(9):1177-1178.
[15] 阮利斌, 何 斌. 腹腔镜结直肠癌根治术的临床疗效及对患者胃肠功能的影响[J]. 腹腔镜外科杂志, 2016,21(8):601-603.
[16] Gorgun E, Yazici P, Onder A, et al. 880 concomitant surgical management of synchronous colorectal cancer and liver metastases: a comparison of open and laparoscopic approaches[J]. Gastroenterol, 2015,148(4):1126.
[17] Attenberger UI, Pilz LR, Morelli JN, et al. Multi-parametric MRI of rectal cancer-Do quantitative functional MR measurements correlate with radiologic and pathologic tumor stages[J]. Eur J Radiol European Journal of Radiology, 2014,83(7):1036-1043.
[18] 叶方进, 金 鑫, 张永智. 腹腔镜结直肠癌根治术治疗结直肠癌患者的疗效及对胃肠功能的影响[J]. 中国肿瘤临床与康复, 2018,25(10):1232-1235.
[19] 张宇飞. 腹腔镜与开腹手术治疗直肠癌的临床效果及并发症对比分析[J]. 中国综合临床, 2017,33(4):353-356.
[20] Du ST, Zhang BM, Liu YL, et al. A novel and safe approach: middle cranial approach for laparoscopic right hemicolon cancer surgery with complete mesocolic Excision[J]. Surgical Endoscopy, 2018,32(5):2567-2574.

相似文献/References:

[1]任小霞,汤晓秋,王艳君,等.不同手术方式子宫切除术对患者生殖系统及性功能的影响[J].陕西医学杂志,2016,(10):1294.
 Ren Xiaoxia,Tang Xiaoqiu,Wang Yanjun,et al.[J].,2016,(8):1294.
[2]龚根强,王建军.开腹手术与腹腔镜手术对治疗结肠癌260例效果评价[J].陕西医学杂志,2016,(09):1177.
[3]伍家发,刘祖定,刘中宁,等.腹腔镜联合经肛门括约肌间超低位直肠癌切除术的临床疗效观察[J].陕西医学杂志,2016,(09):1188.
[4]刘海英,吕燕,刘小红,等.腹腔镜手术与开腹手术治疗异位妊娠150例对比研究[J].陕西医学杂志,2016,(09):1212.
[5]王小刚,高晓峰,杨维桢,等.完全乳晕路径腔镜甲状腺手术172例临床体会[J].陕西医学杂志,2016,(09):1213.
[6]李克峰,王 静,雷 娟.腹腔镜手术治疗脐尿管囊肿疗效及安全性研究*[J].陕西医学杂志,2019,(5):581.
 LI Kefeng,WANG Jing,LEI Juan..Safety evaluation of laparoscopic treatment of urachal cyst[J].,2019,(8):581.
[7]柯东平,毛俊倩,刘 琪,等.TRIM21调控人结直肠癌细胞增殖分子机制研究*[J].陕西医学杂志,2019,(6):691.
 KE Dongping,MAO Junqian,LIU Qi,et al.Study on molecular mechanisms of TRIM21 in regulating proliferation of colorectal cancer[J].,2019,(8):691.
[8]张 慧,陈景志,陈建立△,等.DCC和MKK4基因在结直肠癌组织中的表达及临床意义*[J].陕西医学杂志,2019,(8):968.
 ZHANG Hui,CHEN Jingzhi,CHEN Jianli,et al.Expression and clinical significance of DDC and MKK4 genes in colorectal cancer tissue[J].,2019,(8):968.
[9]赵英旋,白玉勤.结直肠癌患者肿瘤出芽情况与临床病理特征、程序性死亡受体1及程序性死亡配体1表达相关性研究[J].陕西医学杂志,2021,50(6):747.[doi:DOI:10.3969/j.issn.1000-7377.2021.06.027]
 ZHAO Yingxuan,BAI Yuqin.Correlation between tumor budding and clinicopathological characteristics,expression of PD-1 and PD-L1 in CRC[J].,2021,50(8):747.[doi:DOI:10.3969/j.issn.1000-7377.2021.06.027]
[10]马 骞,朱 军,蔡梦珊,等.基于exoRBase外泌体数据库结直肠癌竞争性内源RNA网络构建及富集分析[J].陕西医学杂志,2021,50(7):797.[doi:DOI:10.3969/j.issn.1000-7377.2021.07.007]
 MA Qian,ZHU Jun,CAI Mengshan,et al.Construction and enrichment analysis of competing endogenous RNA network for colorectal cancer based on the exoRBase database[J].,2021,50(8):797.[doi:DOI:10.3969/j.issn.1000-7377.2021.07.007]

更新日期/Last Update: 2019-08-13