腹腔镜全结肠系膜切除术对患者免疫功能和应激反应影响分析.docVIP

腹腔镜全结肠系膜切除术对患者免疫功能和应激反应影响分析 　　[摘要] 目的 分析腹腔?R全结肠系膜切除术对患者免疫功能和应激反应的影响，探讨腹腔镜手术的优势和可行性。 方法 回顾性分析东莞市长安医院和中山市博爱医院2010年1月～2015年12月间收治入院的直肠癌手术患者60例的临床资料，开腹根治性手术30例，成功实施腹腔镜直肠癌根治术30例，对比两组患者手术时间、术中出血量、清扫淋巴结数目、术后肛门排气时间、留置尿管时间、术后住院时间及并发症发生率等指标。并对术后两组患者免疫功能和应激反应进行分析。 结果 观察组手术时间明显长于开腹手术组（P0.05）。观察组术后肛门排气时间、留置尿管时间及术后住院时间明显短于对照组，差异有统计学意义（P0.05）；手术中切除肿瘤时，两组应激指标均明显升高（P0.05）。 结论 腹腔镜全结肠系膜切除术是安全、有效、可行的，值得临床推广应用。 ??　[关键词] 直肠癌；腹腔镜；全直肠系膜切除术；免疫功能；应激反应 　　[中图分类号] R656 [文献标识码] A [文章编号] 2095-0616（2017）08-202-04 　　[Abstract] Objective To analyze the effect of laparoscopic total mesorectal excision on immune function and stress response of patients and to explore the advantages and feasibility of laparoscopic surgery. Methods Clinical data of 60 patients with rectal cancer surgery who were admitted to Changan Hospital and Boai Hospital of Zhongshan from January 2010 to December 2015 were retrospectively analyzed.30 patients were given open radical surgery and 30 patients were given laparoscopic total mesorectal excision.Operation time，intraoperative blood loss，the number of lymph nodes dissection，postoperative anal exhaust time，indwelling catheter time，postoperative hospital stay and the incidence of complications and other indexes of patients in two groups were compared.In addition，the immune function and stress response after operation of two groups were analyzed. Results Operative time of the observation group was significantly longer than that of the open surgery group（P0.05）.Postoperative anal exhaust time，indwelling catheter time and postoperative hospital stay of the observation group were significantly shorter than those of the control group.The difference was statistically significant（P0.05）.At the time of intraoperative tumor resection，stress indexes of the two groups were all significantly increased （P0.05）. Conclusion Laparoscopic total mesorectal excision is safe，effective and feasible，worthy of clinical application. 　　[Key words] Rectal cancer；Laparoscopy；Total mesorectal exci