摘要
目的研究腹腔镜并支架置入(LS-SP)治疗结直肠癌并肠梗阻的临床效果。方法选择2009年7月至2013年6月接受手术治疗的结直肠癌并肠梗阻患者160例,将所有患者分为LSSP组(n=84)与对照组(n=76)。LS-SP组行LS-SP治疗,对照组行开腹治疗。观察2组围手术期指标及术后住院时间、治疗费用,术前及术后7 d的CRP、TNF-α、IL-6等炎性因子水平,术前及术后7 d的CD3^+、CD4^+、CD8^+等T细胞因子水平,术后并发症及1、2、3年生存情况。结果 LS-SP组切口长度、手术时间、术中出血量、术后排气时间及术后住院时间均低于对照组,差异均有统计学意义(P均<0.05)。术后7 d,LS-SP组CRP、TNF-α、IL-6低于对照组,CD3^+、CD4^+高于对照组,CD8^+低于对照组,差异均有统计学意义(P均<0.05)。LS-SP组术后1、2、3年生存率(82.14%、69.05%、50.00%)与对照组(80.26%、67.11%、46.53%)比较差异均无统计学意义(P均>0.05)。LS-SP组术后并发症发生率低于对照组(2.38%vs.13.16%),差异有统计学意义(P<0.05)。结论与开腹治疗相比,LS-SP治疗结直肠癌并肠梗阻创伤小,术后恢复快,术后并发症少且不影响根治效果,值得应用于临床。
Objective To evaluate the clinical efficacy of laparoscopy in combination with stent placement （LS-SP）in treating colorectal cancer complicated with intestinal obstruction. Methods A total of 160 patients with colorectal cancer complicated with intestinal obstruction undergoing surgery between July 2009 to June 2013 were collected and divided into the LS-SP （n=84）and control groups （n=76）. Patients in the LS-SP group underwent LS-SP therapy,and those in the control group received open surgery. Perioperative in-dexes,postoperative length of hospital stay,treatment expense,the levels of inflammatory cytokines such as CRP,TNF-αand IL-6 before and at 7 days after surgery,the levels of lymphokines of T lymphocyte such as CD3 ＋,CD4 ＋and CD8 ＋before and at 7 days after surgery,postoperative complications and the 1-,2-and 3-year survival rates were observed between two groups. Results The length of incision,time of operation,intr-aoperative blood loss,postoperative evacuation time and postoperative length of hospital stay in the LS-SP group were significantly lower than those in the control group （all P〈0.05 ）. At postoperative 7 days,the levels of CRP,TNF-α,IL-6 and CD8^ ＋in the LS-SP group were significantly lower,whereas the levels of CD4^ ＋and CD3^ ＋were significantly higher compared with those in the control group （all P〈0.05 ）. In the LS-SP group, the 1-,2-and 3-year survival rates were 82.14%,69.05% and 50.00%,which did not significantly differ from 80.26%,67.1 1% and 46.53% in the control group （all P〉0.05 ）. The incidence of postoperative complications in the LS-SP group was 2.38%,significantly lower than 13.16% in the control group （P〈0.05 ）. Conclusions Compared with open surgery,LS-SP is an efficacious and safe treatment of colorectal cancer complicated with intestinal obstruction with slight trauma,rapid postoperative recovery and mild postoperative complications,which deserves widespread application in clinical practice.
出处
《新医学》
2016年第12期843-847,共5页
Journal of New Medicine
关键词
腹腔镜
支架置入
结直肠癌
肠梗阻
临床疗效
Laparoscopy
Stent placement
Colorectal cancer
Intestinal obstruction
Clinical efficacy
