小切口右半结肠切除对右半结肠癌患者术后应激、免疫功能和生存情况的影响

摘要
图/表
参考文献
相关文章 (4)

全文:PDF(1829 KB)HTML(1 KB)
输出:BibTeX|EndNote(RIS)

摘要目的：比较小切口右半结肠切除对右半结肠癌患者术后应激、免疫功能和生存情况的影响。方法：回顾性分析2013年3月―2015年10月在我院接受治疗的87例右半结肠癌患者的临床资料。根据治疗方法的不同分为开腹组39例和小切口组48例,开腹组采用开腹手术,小切口组采用右半结肠切除术。观察两组患者围手术期情况和术后并发症情况,比较TNF-α、皮质醇、IL-6水平,以及外周血CD3⁺、CD4⁺、CD4⁺/CD8⁺水平,随访两组患者术后1、2、3年的复发和转移情况。结果：小切口组患者手术时间、切口长度、住院时间明显低于开腹组患者,而出血量两组患者无显著差异。并发症发生情况差异无统计学意义。术后两组患者应激反应指标较术前均显著升高,小切口组应激指标低于开腹组。术后两组患者免疫功能指标较术前均显著降低,小切口组免疫功能指标高于开腹组。两组患者术后1、2、3年的复发和转移情况无显著差异。结论：小切口右半结肠切除术能缩短手术时间、住院时间和降低医疗费用,能够减轻创伤应激反应和提高免疫功能。值得临床推广应用。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	许伟
	周细华
	周锋
	沙德胜

关键词：小切口右半结肠切除术,白细胞介素-6,应激反应,免疫功能

Abstract：ObjectiveTo investigate the effects of small incision for right hemicolectomy on postoperative stress, immune function and short-term survival in patients with right colon cancer.MethodsThe clinical data of 87 patients with right colon cancer who were treated in our hospital from March 2013 to October 2015 were analyzed retrospectively. All of the patients were divided into open group (n=39) and small incision group (n=48), according to different treatment methods. The laparotomy group was treated with laparotomy, and the small incision group was treated with right hemicolectomy. The perioperative conditions and postoperative complications of the two groups were observed. The TNF-α, Cortisol, IL-6, CD3⁺, CD4⁺and CD4⁺/CD8⁺of the two groups were compared. The recurrence and metastasis of the two groups were followed up for 1, 2 and 3 years after operation.ResultsThe surgical time, incision length, and hospitalization time of patients in the small incision group were significantly lower than those in the open surgery group, and there was no statistically significant difference in the incidence of complications between the two groups. The stress response indexes of patients in the two groups after operation were significantly higher than those before operation, and the small incision group were lower than the open group. After operation, the immune function indexes of the two groups were significantly lower than those before operation, and the small incision group were higher than the laparotomy group. There was no significant difference in recurrence and metastasis between the two groups at 1, 2 and 3 years after operation.ConclusionSmall incision right hemicolectomy can shorten the operation time, hospital stay, reduce medical costs, reduce trauma stress response and improve immune function. It is worthy of clinical application.

Key words：small incision right hemicolectomy interleukin-6(IL-6)stress response immune function

收稿日期:2022-09-09

中图分类号:

R656.9

通讯作者:许伟,E-mail：xuwei20062013@163.com

引用本文:

许伟, 周细华, 周锋, 沙德胜. 小切口右半结肠切除对右半结肠癌患者术后应激、免疫功能和生存情况的影响[J]. 金宝搏官方188学报(医学版), 2023, 20(2): 70-73. XU Wei, ZHOU Xihua, ZHOU Feng, SHA Desheng. Effects of small incision for right hemicolectomy on postoperative stress, immune function and short-term survival in patients with right colon cancer. HuNan ShiFan DaXue XueBao(YiXueBan), 2023, 20(2): 70-73.

链接本文:

http://yxb.hunnu.edu.cn/CN/或http://yxb.hunnu.edu.cn/CN/Y2023/V20/I2/70

[1] 姚宏伟, 高加勒, 庞凯, 等. 腹腔镜右半结肠癌切除术后消化道重建的研究现状及前景[J]. 中华消化外科杂志, 2021, 20(3): 255-259.
[2] 李飞, 赵柯, 王翔. 右侧完整结肠系膜切除术对右半结肠癌病人远期预后的影响[J]. 安徽医药, 2022, 26(3): 516-519.
[3] 郭俊江, 蔡小勇, 陈永军, 等. 腹腔镜右半结肠癌完整结肠系膜切除术的相关解剖, 临床应用与思考[J]. 结直肠肛门外科, 2021, 27(3): 295-299.
[4] Damle RN, Macomber CW, Flahive JM, et al.Surgeon volume and elective resection for colon cancer: analysis of outcomes and use of laparoscopy[J]. J Am Coll Surg, 2014, 218(6): 1223-1230.
[5] 刘荫华, 姚宏伟, 周斌, 等. 美国肿瘤联合会结直肠癌分期系统 (第8版) 更新解读[J]. 中国实用外科杂志, 2017, 37(1): 6-9.
[6] 高一飞, 穆向明, 蒋浩海, 等. CME在腹腔镜右半结肠癌根治术中的应用效果及其对应激指标的影响分析[J]. 中华普外科手术学杂志 (电子版, 2017, 11(6): 504-506.
[7] 罗威, 宋彦伟, 孙胜, 等. Ⅲ期右半结肠癌行腹腔镜完整结肠系膜切除术与D3根治术的远期疗效对比[J]. 中国现代普通外科进展, 2021, 24(7): 522-526.
[8] 王锐, 尚静. 腹腔镜右半结肠切除术与开腹手术治疗结肠癌的比较[J]. 中国医药导报, 2017, 14(17): 100-103.
[9] 刘焕然, 胡祥, 刘革, 等. 正中小切口根治性右半结肠切除术 (附9例报告)[J]. 腹腔镜外科杂志, 2018, 23(8): 572-577.
[10] 张学圆. 腹腔镜全结肠系膜切除术对右半结肠癌患者肿瘤标志物及外周血T细胞含量的影响[J]. 中国当代医药, 2022, 29(8): 91-94.
[11] Ishida H, Ishiguro T, Ishibashi K, et al.Impact of prior abdominal surgery on curative resection of colon cancer via minilaparotomy[J]. Surg Today, 2011, 41(3): 369-376.
[12] 王甲南, 卢涛, 崔大炜, 等. 腹腔镜下全结肠系膜切除对右半结肠癌根治术患者手术效果及恢复情况的影响[J]. 中国内镜杂志, 2020, 26(3): 38-42.
[13] 张辰新, 张艺翔, 徐晓东, 等. 经腹部小切口手术在同时性多原发结直肠癌根治手术中的应用[J]. 中国现代手术学杂志, 2020, 24(6): 407-410.
[14] 刘作良, 周彤, 张广军. 小切口与腹腔镜辅助右半结肠切除术对结肠癌患者免疫功能影响的比较[J]. 肿瘤研究与临床, 2017, 29(8): 528-531.
[15] 周珩, 曹会鲲, 胡晓东, 等. 不同入路腹腔镜下完整结肠系膜切除术治疗右半结肠癌并发不全性肠梗阻的疗效[J]. 局解手术学杂志, 2021, 30(4): 325-329.