摘要
目的探索腹腔镜肾细胞癌根治术对T_2期肾细胞癌患者临床疗效、肿瘤相关因子及不良反应的影响。方法选取120例T2期肾细胞癌患者的病历资料,根据治疗方法不同分为腹腔镜组(70例)和开腹组(50例)。观察并比较两组患者术后临床疗效,肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)以及C反应蛋白(CRP)水平及不良反应发生情况。结果腹腔镜组患者术中出血量、下床时间、拔管时间、术后进食时间以及住院天数均明显少于开腹组,手术时间明显长于开腹组,差异均有统计学意义(P<0.01)。腹腔镜组患者术后疗效优于开腹组患者,差异有统计学意义(P<0.05)。术前,两组患者TNF-α、IL-6、CRP水平比较,差异均无统计学意义(P>0.05);术后24 h,腹腔镜组患者TNF-α、IL-6、CRP水平均明显低于开腹组,差异均有统计学意义(P<0.01);术后24 h两组患者TNF-α、IL-6、CRP水平均较本组术前提高,差异均有统计学意义(P<0.05)。腹腔镜组患者不良反应发生例数少于开腹组患者,差异有统计学意义(P<0.05)。结论 T_2期肾细胞癌患者选择腹腔镜根治术治疗能够降低患者肿瘤相关因子水平,提高治疗效果,减少术后不良反应。
Objective To explore the clinical efficacy of laparcoscopic radical nephrectomy in the treatment of stage T2 renal cell carcinoma （RCC） and its influence on tumor-related factors, and the adverse reactions. Method A total of 120 cases of stage T2 RCC were included in the study, who by respective therapy were grouped as laparoscopy group （70 cases） and laparotomy group （50 cases）. The postoperative clinical efficacy, and the level of tumor necrosis factor-α （TNF-α）, interleukin-6 （IL-6） and C-reactive protein （CRP）, as well as the occurrence of adverse reactions of the two groups were observed and compared. Result The laparoscopy group had significantly less intraoperative blood loss, and shorter time to ambulation, to extubation, to postoperative feeding, and fewer days required for hospital stay than the laparotomy group, though longer operative time was observed in laparcoscopy group, and the differences were statistically significant （P〈0.01）. Better clinical efficacy after surgery was noted in laparcoscopy group compared with laparotomy group, showing statistically significant difference （P〈0.05）. The levels of TNF-α, IL-6 and CRP in the two groups paralleled before surgery （P〉0.05）; while they were significantly lower in laparcoscopy group than in laparcotomy group in 24 h after surgery （P〈0.01）, despite a marked postoperative increase was observed in both groups in 24 h, with statistically significant difference observed （P〈 0.05）. Patients with laparoscopy developed less adverse reactions than those who had laparotomy, indicating statistically significant difference （P〈0.05）. Conclusion The choice of laparoscopic radical nephrectomy for stage T2 RCC can reduce the tumor-related factors, improve the therapeutic effect, with lower incidence of postoperative complications.
作者
潘润阳
林荣凯
邓超雄
PAN Runyang;LIN Rongkai;DENG Chaoxiong(Department of Urological Surgery,180^th Hospital of the Chinese People＇s Liberation Army,Quanzhou 362000,Fujian,China)
出处
《癌症进展》
2018年第13期1631-1633,1675,共4页
Oncology Progress
