摘要
目的 探究腹腔镜下回字型右下入路手术与尾侧联合内侧入路手术治疗右半结肠癌的疗效对比。方法 选取2019年9月-2022年9月在淄博一四八医院行右半结肠癌手术的患者60例,随机数字表法将其分为对照组和试验组,各30例。对照组行腹腔镜下尾侧联合内侧入路手术进行治疗;试验组行腹腔镜下回字型右下入路手术治疗。统计2组手术时间、术中出血量、排气时间、排便时间、淋巴结清扫数、住院时间;检测糖类抗原CA19-9(Carbohydrate antigen CA19-9,CA19-9)、糖类抗原CA125(Carbohydrate antigen CA125,CA125)、癌胚抗原(carcinoembryonic antigen,CEA)、MTL、GAS水平;采用VAS评分量表评估患者术后12 h、24 h、48 h不同时间点疼痛程度。结果 试验组手术时间、术中出血量、排气时间均低于对照组(P <0.05);与术前比较,2组术后CA19-9、CA125、CEA水平降低,且试验组较对照组降低更明显(P <0.05);与术前比较,2组术后12 h、24 h、48 h的VAS评分水平均降低,且试验组较对照组降低更显著(P <0.05)。与对照组术后相比,试验组术后MTL、GAS水平升高(P <0.05)。结论 腹腔镜下回字型右下入路手术治疗效果更为显著,能显著改善患者临床症状,改善肿瘤标志物水平,降低疼痛程度,恢复胃肠功能,降低并发症发生率,临床效果较为显著。
Objective To explore the comparison of therapeutic effects between laparoscopic right lower approach surgery with zigzag shape and caudal combined with medial approach surgery in right hemicolon cancer.Methods 60 patients who underwent right colon cancer surgery in Zibo 148 Hospita from September 2019 to September 2022 were selected and divided into the control group and the experiment group according to random munber table method,with 30 patients in each group.The control group underwent laparoscopic caudal combined with medial approach surgery and the experiment group underwent laparoscopic right lower approach surgery with zigzag shape.The operation time,intraoperative blood loss,exhaust time,defecation time,lymph node dissection number and hospitalization time of two groups were counted.The levels of carbohydrate antigen 19-9(CA19-9),CA125,carcinoembryonic antigen(CEA),MTL,and GAS were detected.VAS score scale was used to assess the pain level of the patients at different time points at 12 hours,24 hours,and 48 hours after the surgery.Results The operation time,intraoperative blood loss and exhaust time of the experiment group were lower than those of the control group(P<0.05).Compared with before operation,the levels of CA19-9,CA125 and CEA in two groups were decreased,and the levels in the experiment group were more significantly decreased than those in the control group(P<0.05).Compared with before operation,the VAS scores of both groups decreased at 12,24,and 48 hours after the surgery,and the experiment group showed the more significant decrease compared with the control group(P<0.05).Compared with the control group after surgery,the levels of MTL and GAS in the experiment group increased after surgery(P<0.05).Conclusion The laparoscopic right lower approach surgery with zigzag shape has the more significant treatment effect,which can significantly improve the clinical symptoms of patients,improve the levels of tumor markers,reduce the degree of pain,restore gastrointestinal function,and reduce the incidence of complications.The clinical effect of this treatment method is more significant.
作者
周文广
史进
ZHOU Wenguang;SHI Jin(Zibo 148 Hospital,Zibo 255300,China)
出处
《长春中医药大学学报》
2024年第1期75-78,共4页
Journal of Changchun University of Chinese Medicine
基金
山东省卫健委健康委员会计划项目(20204F28)。
关键词
右半结肠癌
腹腔镜
回字型右下入路手术
尾侧联合内侧入路手术
肿瘤标志物
right colon cancer
laparoscopy
right lower approach surgery with zigzag shape
caudal combined with medial approach surgery
tumor marker
