腹腔镜结直肠癌根治术对结直肠癌患者氧化应激及能量代谢的影响
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摘要
目的探讨腹腔镜结直肠癌根治术对结直肠癌患者氧化应激及能量代谢的影响。方法选择2016年10月至2017年9月佳木斯大学附属第一医院收治的结直肠癌患者72例为研究对象,采用随机数字表法分为观察组和对照组各36例。对照组给予开腹结直肠癌根治术,观察组给予腹腔镜结直肠癌根治术。比较两组手术相关指标、氧化应激反应、能量代谢及术后并发症。结果观察组患者手术时间明显长于对照组,术中出血量明显少于对照组,术后排气时间、住院时间明显短于对照组,两组比较差异有统计学意义(P<0.05);术后3d,观察组患者血清丙二醛(MDA)水平明显低于对照组,超氧化物歧化酶(SOD)水平明显高于对照组,两组比较差异有统计学意义(P<0.05);观察组患者血清前清蛋白(PA)、清蛋白(ALB)、转铁蛋白(TRE)、视黄醇蛋白(RBP)水平明显高于对照组(t=3.550、3.966、5.897、8.642,P<0.05);肠梗阻等并发症发生率(11.11%)明显低于对照组(36.11%),两组比较差异有统计学意义(χ~2=5.143,P<0.05)。结论腹腔镜结直肠癌根治术有助于促进患者术后恢复,降低不良反应发生,可能与减轻氧化应激反应、抑制能量代谢波动等因素有关。
引文
[1]吴泽华,邓艳红.结直肠癌流行病学东西方差异对肿瘤部位的影响[J].中国癌症防治杂志,2017,9(5):356-360.
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[12]赵玉,滕成玲,苗素琴.不同剂量乌司他丁对老年直肠癌患者腹腔直肠癌患者腔镜术后早期认知功能的影响及机制探讨[J].实用药物与临床,2017,20(10):1163-1166.
[13]丁海涛,帕尔哈提·阿布都热衣木,韩智君,等.结直肠癌NOSE术对患者氧化应激、免疫功能及机体微炎症的影响[J].中国现代手术学杂志,2017,21(1):9-13.
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[15]吴涛,陆春雷,葛晨,等.腹腔镜用于结直肠癌根治术对患者围术期机体代谢及胃肠功能的影响[J].广西医科大学学报,2017,34(10):1498-1499.
[16]URATANI R,TOIYAMA Y,SHIMURA T,et al.Preoperative lower body mass index correlates with poorer prognosis in patients undergoing curative laparoscopic surgery for colorectal cancer[J].Anticancer Res,2015,35(10):5639-5648.
[17]SHIM B Y,JUNG J H,LEE K M,et al.Glucose transporter 1(GLUT1)of anaerobic glycolysis as predictive and prognostic values in neoadjuvant chemoradiotherapy and laparoscopic surgery for locally advanced rectal cancer[J].Int J Colorectal Dis,2013,28(3):375-383.
[18]姜飚,李晓剑,靳猛,等.腹腔镜直肠癌根治术患者围术期炎性状态及机体代谢的变化[J].疑难病杂志,2015,14(4):366-368.
[19]张传海,栾宁.腹腔镜结直肠癌根治术对高龄患者胃肠功能的影响[J].中国现代普通外科进展,2017,20(7):552-554
[20]TAJIMA T,MUKAI M,YOKOYAMA D,et al.Comparison of hand-assisted laparoscopic surgery(HALS)and conventional laparotomy in patients with colorectal cancer:Final results from a single center[J].Oncol Lett,2017,13(6):4953-4958.
[2]曹广,梁杰雄,李洋,等.腹腔镜结直肠癌根治术治疗不同分期结直肠癌的效果及安全性分析[J].中国医药,2017,12(4):566-570.
[3]YANG X,WU Q,JIN C,et al.A novel hand-assisted laparoscopic versus conventional laparoscopic right hemicolectomy for right colon cancer:study protocol for a randomized controlled trial[J].Trais,2017,18(1):355.
[4]TORRALBA M,OLIVARES C M,MARTINEZ M L,et al.C-reactive protein as a marker of the surgical stress reduction within an ERAS protocol(Enhanced Recovery After Surgery)in colorectal surgery:A prospective cohort study[J].J Surg Oncol,2018,117(4):717-724.
[5]郑威强,章烈,程勇.梗阻性结直肠癌导管减压后3D腹腔镜与开腹手术的疗效比较[J].中国普通外科进展,2017,26(10):1286-1290.
[6]KIM Y W,KIM I Y.Comparison of the short-term outcomes of laparoscopic and open resections for colorectal cancer in patients with a history of prior median laparotomy[J].Indian J Surg,2017,79(6):527-533.
[7]戚文元,戎吉龙.腹腔镜与开腹直肠癌根治术对患者远期预后的影响及相关因素分析[J].中国中西医结合外科杂志,2017,23(1):84-86.
[8]丛进春,陈春生,冯勇,等.右半结肠癌患者完整系膜切除术与D3根治术的腹腔镜与开腹手术的短期结果比较[J].中国肿瘤临床,2014,41(24):1591-1596.
[9]MARTINEZ A B,LONGAS J,RAMIREZ J M.A model for lymphocyte activation in open versus laparoscopic surgery in colorectal cancer patients in enhanced recovery after surgery(ERAS)protocols[J].Int J Colorectal Dis,2017,32(6):913-916.
[10]何利,何茂梁,袁波,等.腹腔镜手术对结直肠癌患者血清炎性因子、VEGF、MMP-9、氧化应激及免疫功能的影响[J].海南医学院学报,2017,23(18):2546-2549.
[11]PAPPAS-GOGOS G,TELLIS C,LASITHIOTAKIS K,et al.Oxidative stress markers in laparoscopic versus open colectomy for cancer:a double-blind randomized study[J].Surg Endosc,2013,27(7):2357-2365.
[12]赵玉,滕成玲,苗素琴.不同剂量乌司他丁对老年直肠癌患者腹腔直肠癌患者腔镜术后早期认知功能的影响及机制探讨[J].实用药物与临床,2017,20(10):1163-1166.
[13]丁海涛,帕尔哈提·阿布都热衣木,韩智君,等.结直肠癌NOSE术对患者氧化应激、免疫功能及机体微炎症的影响[J].中国现代手术学杂志,2017,21(1):9-13.
[14]张传强,华浩东.腹腔镜直肠癌根治术对患者血清炎症因子及氧化应激反应的影响[J].川北医学院学报,2017,32(5):771-774.
[15]吴涛,陆春雷,葛晨,等.腹腔镜用于结直肠癌根治术对患者围术期机体代谢及胃肠功能的影响[J].广西医科大学学报,2017,34(10):1498-1499.
[16]URATANI R,TOIYAMA Y,SHIMURA T,et al.Preoperative lower body mass index correlates with poorer prognosis in patients undergoing curative laparoscopic surgery for colorectal cancer[J].Anticancer Res,2015,35(10):5639-5648.
[17]SHIM B Y,JUNG J H,LEE K M,et al.Glucose transporter 1(GLUT1)of anaerobic glycolysis as predictive and prognostic values in neoadjuvant chemoradiotherapy and laparoscopic surgery for locally advanced rectal cancer[J].Int J Colorectal Dis,2013,28(3):375-383.
[18]姜飚,李晓剑,靳猛,等.腹腔镜直肠癌根治术患者围术期炎性状态及机体代谢的变化[J].疑难病杂志,2015,14(4):366-368.
[19]张传海,栾宁.腹腔镜结直肠癌根治术对高龄患者胃肠功能的影响[J].中国现代普通外科进展,2017,20(7):552-554
[20]TAJIMA T,MUKAI M,YOKOYAMA D,et al.Comparison of hand-assisted laparoscopic surgery(HALS)and conventional laparotomy in patients with colorectal cancer:Final results from a single center[J].Oncol Lett,2017,13(6):4953-4958.