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

目的:探讨腹腔镜直肠癌根治术(laparoscopic radical rectectomy,LRR)对患者血清炎症因子及氧化应激反应的影响。方法:选取符合直肠癌根治术指征患者87例,按治疗时间不同分为LRR组47例和开腹直肠癌根治术(open radical rectectomy,ORR)组40例。观察两组手术情况及术后感染发生情况,比较两组手术前后白细胞介素-6(IL-6)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、丙二醛(MDA)及超氧化物歧化酶(SOD)水平。结果:与ORR组比较,LRR组手术时间及肠道功能恢复时间明显缩短,术中出血量明显减少(P<0.05或P<0.01)。术后1 d、3 d、5 d,两组IL-6、CRP、TNF-α水平较术前明显升高(P<0.05或P<0.01),术后3 d逐渐降低;术后1 d、3 d、5 d,LRR组IL-6、CRP、TNF-α水平明显低于ORR组(P<0.01)。术后1 d、3 d,两组MDA水平较术前明显升高,SOD水平明显降低,但ORR组升高和降低程度更为显著(P<0.01);术后5 d,两组MDA、SOD比较无显著差异(P>0.05)。LRR组术后感染发生率低于ORR组(P<0.05)。结论:LRR能有效减轻手术创伤,缩短手术时间,且对机体炎症和氧化应激反应影响较小,利于术后恢复。

Influence of LRR for rectal cancer on patients' serum inflammatory factors and oxidative stress response

Objective:To explore the influence of laparoscopic radical rectectomy(LRR) for rectal cancer on patients' serum inflammatory factors and oxidative stress response.Methods:A total of 87 patients who conformed to the indications of LRR were divided into LRR group (n =47) and open radical rectectomy for rectal cancer (ORR) group (n =40) by different surgical periods.Surgical condition and postoperative infection condition were observed in both groups,while the levels of interleukin-6 (IL-6),C-reactive protein (CRP),tumor necrosis-α (TNF-α),malondialdehyde (MDA) and superoxide dismutase (SOD) were compared between two groups before and after operation.Results:Compared with ORR group,LRR group was markedly shorter in surgical duration and recovery time of gastrointestinal function,and notably lower in intraoperative hemorrhagic volume (P ＜ 0.05 or P ＜ 0.01).1 d,3d and 5d after operation,the levels of IL-6,CRP and TNF-α increased in both groups than before (P ＜ 0.05 or P ＜ 0.01),but decreased gradually since 3d after operation.However,1 d,3d and 5 d after operation,LRR group was prominently lower than O RR group in the levels of IL-6,CRP and TNF-α (P ＜ 0.01).1 d and 3d after operation,MDA level increased while SOD level decreased markedly in both groups,but they changed more significantly in ORR group than that in LRR group (P ＜ 0.01).5d after operation,there was insignificant difference between two groups in the levels of MDA and SOD (P ＞ 0.05).Meanwhile,LRR group was evidently lower than ORR group in the rate of postoperative infection (P ＜ 0.05).Conclusion:LRR can effectively relieve surgical trauma,shorten surgical duration,has less influence of body's inflammation and oxidative stress response,and is beneficial to the postoperative recovery.