2019 年第 11 期 第 14 卷

腹腔镜结直肠癌根治术临床效果分析及对患者凝血功能和T淋巴细胞水平的影响

Clinical effect of laparoscopic radical resection of colorectal cancer and the effect on coagulation function and T lymphocyte level

作者：王钊彭林涛杨帆栗斌

英文作者：

单位：054000河北省邢台市人民医院普外科（王钊、彭林涛），烧伤科（杨帆），CT/MR科（栗斌）

英文单位：

关键词：结直肠癌根治术；腹腔镜；凝血功能；淋巴细胞；临床效果

英文关键词：

• 摘要：

• 【摘要】目的    本研究分析腹腔镜结直肠癌根治术的临床效果及对患者凝血功能和T淋巴细胞水平的影响，为临床治疗提供参考。方法    选取2016年6月至2018年12月河北省邢台市人民医院诊治的170例结直肠癌患者为研究对象。完全随机分为观察组和对照组，各85例。对照组患者行常规开放式手术，观察组患者给予腹腔镜结直肠癌根治术。比较2组的临床效果、凝血功能、T淋巴细胞水平。观察术后下肢静脉超声检查结果。结果    观察组手术时间、术中出血量、腹胀持续时间及肛门排气时间短于/少于对照组，而术后胃动素及胃泌素水平高于对照组［（113±16）min比（185±24）min、（50±9）ml比（95±12）ml、（3.3±0.5）d比（4.8±0.6）d、（2.9±0.8）d比（4.1±0.9）d、（80±7）ng/L比（59±13）ng/L、（227±32）ng/L比（146±24）ng/L］，差异均有统计学意义（均P<0.05）。治疗前后观察组与对照组凝血功能指标差异均无统计学意义（均P>0.05）。2组治疗24 h后CD+3、CD+4及CD+8相对水平均较治疗前24 h明显降低，且观察组低于对照组［（33±4）%比（42±5）%、（24±6）%比（34±4）%、（20±3）%比（29±3）%］，差异均有统计学意义（均P<0.05）。2组患者术后下肢静脉超声检查均无血栓形成。结论    腹腔镜结直肠癌根治术临床效果好而不影响凝血功能，且更有利于免疫功能的恢复。

• 【Abstract】Objective    To analyze the clinical effect of laparoscopic radical resection of colorectal cancer and the effect on coagulation function and T lymphocyte level, providing reference for clinical treatment. Methods    A total of 170 patients with colorectal cancer were enrolled from June 2016 to December 2018 at Xingtai People′s Hospital, Hebei Province. They were randomly divided into observation group and control group, with 85 cases in each group. The control group underwent routine open surgery, while the observation group underwent laparoscopic radical resection of colorectal cancer. Clinical effect, coagulation function, T lymphocyte level and postoperative ultrasonic results of lower extremities were analyzed. Results    Operation time, intraoperative blood loss, duration time of abdominal distension and anal exhaust time in observation group were significantly shorter/less than those in control group; levels of motilin and gastrin postoperative in observation group were significantly higher than those in control group［（113±16）min vs （185±24）min, （50±9）ml vs （95±12）ml, （3.3±0.5）d vs （4.8±0.6）d, （2.9±0.8）d vs （4.1±0.9）d, （80±7）ng/L vs （59±13）ng/L, （227±32）ng/L vs （146±24）ng/L］(all P<0.05). There were no significant difference in coagulation function indexes between groups before and after treatment(all P>0.05). At 24 h after operation, levels of CD+3, CD+4 and CD+8 were significantly lower than those at 24 h before treatment in both groups; the levels in observation group were lower than those in control group［（33±4）% vs （42±5）%, （24±6）% vs （34±4）%, （20±3）% vs （29±3）%］(all P<0.05). No thrombosis was observed in veins of lower extremities by ultrasonography after operation. Conclusion    Laparoscopic radical resection of colorectal cancer has good clinical effect without affecting coagulation function and is conducive to the recovery of immune function.