摘要
目的:探讨腹腔镜直肠癌根治术对患者的肛肠动力学及抗炎状态的影响。方法:收集在本院进行腹腔镜直肠癌根治术的患者60例为腹腔镜组,纳入同时期来本院经检查确认非直肠癌的患者60例为对照组。比较术前腹腔镜组和对照组间肛肠动力学指标肛管静息压(ARP)、肛管最大收缩压(MSP)、高压区长度(HPZ)、直肠静息压(RRP)、肛管蠕动波频率(APWF)、直肠最大耐受容量(MTV)、直肠肛管抑制反射阈值(AIRT)差异。比较腹腔镜组术前及术后第1天、第7天、第14天血清炎症指标水平差异。结果:腹腔镜组与对照组间各项肛肠动力学指标比较,差异无统计学意义(P>0.05);术后第15天,腹腔镜组ARP、MSP、HPZ、MTV明显下降,而RRP、AIRT则明显上升,差异具有统计学意义(P<0.05),APWF无明显改变。从手术后第1个月开始,各项指标开始逐渐恢复,术后第3、6个月各项指标与术前相比均无明显差异。术后第1天腹腔镜组的血清炎症因子白介素-6(IL-6)、白介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)、血清淀粉样蛋白A(SAA)水平明显高于术前,差异具有统计学意义(P<0.05);术后第7天开始各项指标逐渐恢复,术后第15天各项指标与术前相比,差异无统计学意义(P>0.05)。结论:腹腔镜直肠癌根治术对患者的肛肠动力学有短期、暂时的影响,术后3个月肛肠动力学能恢复正常;术后患者体内发生剧烈的抗炎反应,术后第15天恢复正常。
Objective：To observe the influence of laparoscopic colorectal cancer resection for the anorectal dynamics and anti-inflammatory state of patients with colorectal cancer.Methods：A total of 60 cases of patients with colorectal cancer that were scheduled for undergoing laparoscopic treatment were selected as laparoscopic group,60 cases of confirmed non-colorectal cancer patients during the same period were enrolled as control group.The indexes of anorectal dynamic such as ARP（anal resting pressure）,MSP（maximal squeezing pressure）,HPZ（high pressure zone length）,RRP（rectal resting pressure）,APWF（anal peristaltic wave frequency）,MTV（maximal tolerable rectal volume,）AIRT（anorectal inhibitory reflex threshold）of two groups were detected and compared,serum levels of inflammatory markers before and after undergoing the treatment were also compared.Results：There were no significant difference in indexes of anorectal dynamic between laparoscopic group and control group（P〉0.05）.The first 15 days after surgery,the indexes such as ARP,MSP,HPZ and MTV of laparoscopic group were significantly decreased,while the RRP and AIRT were significantly increased（Pall〈0.05）.From the first month after undergoing surgery,the indicators began to recover,no significant differences was found in indicators 3and 6months after undergoing the surgery comparing with levels before the surgery.The first day after surgery,the serum levels of inflammatory markers such as IL-6（interleukin-6）,IL-8（interleukin-8）,TNF-α（tumor necrosis factor-α）,CRP（C-reactive protein）and SAA（serum amyloid A）were significantly increased（Pall〈0.05）;from the first 7days after surgery,these indicators began to recover,and there was no significantly difference compared to levels before surgery on the 15 th days after surgery.Conclusion：The influence of laparoscopic colorectal cancer resection for the anorectal dynamics and anti-inflammatory state were shortterm and temporary,the anorectal dynamics can be restored to normal 3months after surgery,the anti-inflammatory response can be restored to normal 15 days after surgery.
出处
《海南医学院学报》
CAS
2015年第1期127-130,共4页
Journal of Hainan Medical University
基金
湖北省自然科学基金(hb2817223)~~
关键词
腹腔镜直肠癌根治术
肛肠动力学
抗炎状态
Laparoscopic colorectal cancer resection
Anorectal dynamics
Anti-inflammatory state
