低位三管引流对梗阻性直肠癌一期保肛术后血自由基水平影响.docVIP

低位三管引流对梗阻性直肠癌一期保肛术后血自由基水平的影响 　　【中图分类号】R735.3?+7【文献标识码】A【文章编号】1005-2720(2009)09-0283-02 　　【摘要】目的：了解低位引流对直肠癌性梗阻患者一期术后血自由基水平的影响。方法：一期切除吻合的直肠癌性梗阻患者30例，按术后引流方法分为骶前引流组(B)及低位三管引流(经肛双管引流+骶前引流)组(C)两组，观察每组手术前后外周血MDA及SOD水平变化。另选取15例择期手术的非梗阻性直肠癌患者为对照组(A)。结果：①B、C组患者术后外周血MDA水平均呈下降趋势，而SOD水平呈上升趋势；②术后4d始C组患者MDA水平显著低于而SOD水平显著高于B组与对照组(P0.05)。结论：低位三管引流能显著降低直肠癌性梗阻患者一期术后机体自由基产生。 　　【关键词】引流；直肠癌；梗阻；保肛；自由基 　　 　　The effects of lower drainage by three tubes on free radicals after annus-preserving operation in patients with obstructive rectal carcinomas.Zhou Yuntian，Liu Xiantang，Wu Yin?ai，et al.(The people?s hospital of Huidong country，Guangdong 516300) 　　【Abstract】Objective：To study the effects of lower drainage by three tubes on free radicals after annus-preserving operation in patients with obstructive rectal carcinomas.Methods：Thirty patients with obstructive rectal carcinomas were divided into two groups according to postoperative drainage patterns.They were presacral drainage group (groupB)，and lower drainage by three tubes group (group C).Presacral drainage was underwent in Group B，and presacral drainage+drainage through anus with two tubes were underwentin Group C.Fifteen patients with non-obstructive rectal carcinomas，who underwent selective operation，were chosen randomly as control group (group A).Results：①There was falling tendency to MDA levels and rising tendency to SOD levels in peripheral blood for group B and C after operation.②On the forth and sixth day after operation，the MDA levels was lower and the SOD levels was higher in group C than those in group B and A (P0.05).Conclusion：Lower drainage by three tubes can reduce the production of free radicals after operation in patients with obstructive rectal carcinomas. 　　【Key Words】Drainge；Rectal carcinomas；Obstruction；Annus-preserving；Free radicals 　　 　　氧自由基对机体有损害作用，超氧化物歧化酶(superoxide dismutase，SOD)是机体中的主要抗氧化酶，能特异性清除超氧阴离子而起保护细胞的作用，其水平高低反映了机体抗氧化能力。丙二醛(malonialdehyde，MDA)是脂质过氧化物的中间分解产物，为反映氧自由基诱导的机体脂质过氧化损伤的程度。笔者对直肠癌梗阻患者一期保肛术前