腹腔镜下钉座反穿吻合法联合经自然腔道取标本对低位直肠癌患者疗效及生活质量的影响

目的 探究腹腔镜下钉座反穿吻合法联合经自然腔道取标本对低位直肠癌患者治疗效果及生活质量影响。方法 选取我院2018年4月至2021年6月收治的86例低位直肠癌患者作为研究对象，以简单随机化法（1:1）将其分为研究组和对照组，均43例，2组患者于腹腔镜下行直肠癌根治术并经自然腔道取标本，对照组联合传统荷包式缝合固定，研究组联合钉座反穿吻合法固定。比较2组患者手术指标术中出血量、手术时间、术后初次排气时间及住院时间]、炎性因子C-反应蛋白（CRP）、肿瘤坏死因子（TNF-α）]、免疫因子免疫球蛋白G（lgG）]、氧化应激指标丙二醛（MDA）、超氧化物歧化酶（SOD）]及术后并发症发生情况，并对2组患者术前及术后生活质量进行评估。结果 研究组术中出血量、手术时间及住院时间均少于对照组（P＜0.05）。术后，2组血清CRP、TNF-α水平及对照组lgG水平均高于术前（P＜0.05）；研究组术后血清CRP、TNF-α、lgG水平均低于对照组（P＜0.05）。2组术后血清MDA水平均高于术前，SOD水平均低于术前（P＜0.05）；研究组术后血清MDA水平低于对照组，SOD水平高于对照组（P＜0.05）。研究组术后并发症发生率低于对照组（P＜0.05）。2组患者术前生活质量评分比较差异无统计学意义（P＞0.05）；术后2组患者的生活质量评分较术前均升高，研究组高于对照组（P＜0.05）。结论 腹腔镜下钉座反穿吻合法联合经自然腔道取标本治疗低位直肠癌患者，可有效降低术中出血量，缩短术后恢复时间，稳定各项血清炎症因子及氧化应激指标水平，临床疗效较好且并发症发生率低。

Effect of laparoscopic nail seat reverse anastomosis combined with specimen collection through natural cavity on the treatment effect and quality of life of patients with low rectal cancer

Objective To explore the effect of laparoscopic nail seat reverse anastomosis combined with specimen collection through natural cavity on the treatment effect and quality of life of patients with low rectal cancer. Methods We selected 86 patients with low rectal cancer admitted to our hospital from April 2018 to June 2021 as the research objects, and divided them into a study group and a control group by a simple randomization method (1:1), with 43 cases in each group, 2 groups The patients underwent laparoscopic radical resection of rectal cancer and samples were taken through the natural cavity. The control group was fixed with traditional purse-string suture, and the study group was fixed with screw base reverse anastomosis. Comparison of surgical indicators intraoperative blood loss, operation time, first postoperative exhaust time and hospital stay], inflammatory factors C-reactive protein (CRP), tumor necrosis factor (TNF-α)], immune factors in the two groups Immunoglobulin G (lgG)], oxidative stress indicators malondialdehyde (MDA), superoxide dismutase (SOD)] and postoperative complications, and the preoperative and postoperative life of the two groups The quality is evaluated. Results The amount of blood loss, operation time and hospital stay in the study group were less than those in the control group (P<0.05). After operation, the levels of serum CRP, TNF-α and lgG in the control group were higher than those in the control group after operation (P＜0.05), the postoperative serum CRP, TNF-α, and lgG levels in the study group were lower than those in the control group (P＜0.05) ). The postoperative serum MDA level in the two groups was higher than that before operation, and the SOD level was lower than before operation (P<0.05), the postoperative serum MDA level in the study group was lower than the control group, and the SOD level was higher than the control group (P<0.05). The incidence of postoperative complications in the study group was lower than that in the control group (P＜0.05). There was no significant difference in the quality of life scores between the two groups before surgery (P>0.05), the quality of life scores of the two groups after surgery were higher than those before surgery, and the study group was higher than the control group (P<0.05). Conclusion Laparoscopic nail seat reverse anastomosis combined with natural cavity sampling to treat patients with low rectal cancer can effectively reduce intraoperative blood loss, shorten postoperative recovery time, and stabilize the levels of serum inflammatory factors and oxidative stress indicators. The curative effect is better and the complication rate is low.