纳米碳示踪技术引导下腹腔镜直肠癌根治术的临床疗效观察
|
摘要
目的观察纳米碳淋巴示踪剂腹腔镜直肠癌根治术治疗直肠癌的临床疗效及应用价值。方法收集100例直肠癌患者,分为观察组和对照组,观察组患者在纳米碳示踪剂引导下行腹腔镜直肠癌根治术,对照组患者行常规腹腔镜直肠癌根治术,比较2组手术时间、术中出血情况、术后住院治疗时间、肛门排气时间、体温恢复时间、淋巴检出数目、淋巴转移情况,以及患者血清IL-17和IL-10水平。结果与对照组比较,观察组手术时间更短,术中出血量更少,术后住院时间更短,肛门排气、体温恢复时间更快,术后并发症发生率更低,差异具有统计学意义(P <0.05)。与治疗前比较,2组治疗后IL-17、IL-10水平均下降明显,差异具有统计学意义(P <0.05),治疗后与对照组比较,观察组IL-17、IL-10水平下降更为明显,差异具有统计学意义(P <0.05)。治疗后观察组每例患者清扫淋巴结数目多于对照组,差异具有统计学意义(P <0.05)。观察组检出转移淋巴结6枚,淋巴结转移率为1.2%,对照组检出转移淋巴结4枚,淋巴结转移率为1.0%,2组比较差异无统计学意义(P>0.05)。结论纳米碳淋巴示踪剂在腹腔镜直肠癌根治术作用明显,能够定位病灶,缩短术中时间,减少术中出血量,提高临床疗效,调节患者血清IL-17和IL-10的水平。
Objective To observe the clinical efficacy and application value of carbon nanoparticles tracer technique after laparoscopic rectal resections.Methods 100 patients patients with rectal cancer were randomly divided into observation group(laparoscopic surgery with carbon nanoparticles tracer)and control group(conventional laparoscopic surgery)with each 50 cases.Intraoperative bleeding,postoperative hospitalization time,anal exhaust time,body temperature recovery time,lymphatic count,lymphatic metastasis,and serum IL-17 and IL-10 levels were tested.Results Compared with the control group,the observation group had shorter operation time,less intraoperative blood loss,shorter postoperative hospital stay,faster recovery of anal exhaust and body temperature,and lower postoperative complication rate.The difference was statistically significant(P <0.05).The levels of IL-17 and IL-10 decreased significantly in two groups after the treatment(P <0.05).After the treatment,the levels of IL-17 and IL-10 in the observation group decreased more significantly compared to the control group(P <0.05).After treatment,the number of lymphadenectomy in observation group was higher than that in the control group(P <0.05).In the observation group,6metastatic lymph nodes were detected,and the lymph node metastasis rate was 1.2%,while 4metastatic lymph nodes were detected in the control group,the lymph node metastasis rate was 1.0%.There was no significant difference between two groups(P >0.05).Conclusion Laparoscopic surgery with carbon nanoparticles tracer has obvious effects in rectal cancer radical resection.It can locate lesions,shorten intraoperative time,reduce intraoperative bleeding,improve clinical efficacy,and regulate serum IL-17 and IL-10 levels.
Objective To observe the clinical efficacy and application value of carbon nanoparticles tracer technique after laparoscopic rectal resections.Methods 100 patients patients with rectal cancer were randomly divided into observation group(laparoscopic surgery with carbon nanoparticles tracer)and control group(conventional laparoscopic surgery)with each 50 cases.Intraoperative bleeding,postoperative hospitalization time,anal exhaust time,body temperature recovery time,lymphatic count,lymphatic metastasis,and serum IL-17 and IL-10 levels were tested.Results Compared with the control group,the observation group had shorter operation time,less intraoperative blood loss,shorter postoperative hospital stay,faster recovery of anal exhaust and body temperature,and lower postoperative complication rate.The difference was statistically significant(P <0.05).The levels of IL-17 and IL-10 decreased significantly in two groups after the treatment(P <0.05).After the treatment,the levels of IL-17 and IL-10 in the observation group decreased more significantly compared to the control group(P <0.05).After treatment,the number of lymphadenectomy in observation group was higher than that in the control group(P <0.05).In the observation group,6metastatic lymph nodes were detected,and the lymph node metastasis rate was 1.2%,while 4metastatic lymph nodes were detected in the control group,the lymph node metastasis rate was 1.0%.There was no significant difference between two groups(P >0.05).Conclusion Laparoscopic surgery with carbon nanoparticles tracer has obvious effects in rectal cancer radical resection.It can locate lesions,shorten intraoperative time,reduce intraoperative bleeding,improve clinical efficacy,and regulate serum IL-17 and IL-10 levels.
引文
[1]American Cancer Society.Global Cancer Facts&Figures 2007[M].Atlant,GA:American Cancer Society,2007:12-13.
[2]黄力若,伍忠礼,梁发亮,等.纳米碳淋巴示踪剂用于腹腔镜结直肠癌手术的价值分析[J].中国实用医药,2016,11(17):183-184.
[3]LACY A M,ADELSDORFER C.Totally transrectal endoscopic total mesorectal excision(TME)[J].Colorectal Dis,2011,13(7):43-46.
[4]KELLOKUMPU IH,KAIRALUOMA MI,NUORVA KP,et al.Short and long term outcome following laparoscopic versus open resection for carcinoma of the rectum in the multimodal setting[J].Dis Colon Rectum,2012,55(8):854-863.
[5]宗亮,陈平,赵伟,等.国内腹腔镜与开腹结直肠癌手术治疗术后并发症的Meta分析[J].中华临床医师杂志:电子版,2012,6(3):648-652.
[6]胡辉,荆绪斌,严江,等.腹腔镜与结肠镜联合诊治大肠病变的应用[J].中华临床医师杂志:电子版,2011,5(11):3343-3344.
[7]傅骏,郁宝铭,卞国伟,等.纳米碳标记在结直肠癌根治术中的应用[J].结直肠肛门外科,2009,15:160-162.
[8]史衍辉,夏璐,南林,等.纳米碳引导下腹腔镜中低位直肠癌根治术的近期疗效分析[J].中华临床医师杂志:电子版,2012,6(21):6682-6684.
[9]颜博,葛洁,张斌,等.纳米碳在乳腺癌前哨淋巴结活检中的临床应用[J].中国肿瘤临床,2011,38(21):1335-1337.
[10]夏旭,刘伟,欧勇,等.纳米碳引导下腹腔镜中低位直肠癌根治术24例临床观察[J].中国临床研究,2015,28(6):776-778.
[11]赵纲,童汉兴,刘凤林,等.纳米碳在腹腔镜中低位直肠癌根治术中的应用价值[J].中华实验外科杂志,2009,23(26):1204-1206.
[12]张相春.纳米碳淋巴示踪剂在腹腔镜结直肠癌手术中的应用以及前哨淋巴结活检的临床意义[D].山东大学,2015.
[13]李坚,张阳德,龚连生,等.侧方淋巴结清扫在低位直肠癌根治术中的应用[J].中华临床医师杂志:电子版,2011,5(11):3141-3145.
[14]田相安,杨成菊,丁元升,等.纳米炭导航腹腔镜中低位直肠癌根治术个体化淋巴结清除的临床研究[J].中国现代普通外科进展,2017,20(3):188-192.
[15]林周,俞宪明,黄敏娴,等.纳米碳染色在直肠癌侧方淋巴结清扫中的应用研究[J].实用临床医药杂志,2010,14(9):50-51.
[16]陈涛,华一兵.纳米碳和亚甲蓝在结直肠癌根治术淋巴结检出中的应用[J].临床和实验医学杂志,2016,15(24):2410-2414.
[17]茅慧,千年松,周艳华,等.白介素17与结直肠癌[J].现代生物医学进展,2016,16(19):3776-3778.
[18]王建升.Th17/Treg细胞及相关细胞因子在结直肠癌发展过程中的变化[D].首都医科大学,2012.
[19]戚红霞,李晓虹,胡海强.血清IGF-1、IGFBP-3、VEGF及多项白介素在结直肠癌转移监测中的意义[J].海南医学院学报,2013,19(2):176-179.
[20]庄佳娥,庄柏润,包冕,等.直肠癌行腹腔镜与开放术后感染致病菌分析与干扰素、白介素水平观察[J].中国医药科学,2017,7(14):11-14.
[2]黄力若,伍忠礼,梁发亮,等.纳米碳淋巴示踪剂用于腹腔镜结直肠癌手术的价值分析[J].中国实用医药,2016,11(17):183-184.
[3]LACY A M,ADELSDORFER C.Totally transrectal endoscopic total mesorectal excision(TME)[J].Colorectal Dis,2011,13(7):43-46.
[4]KELLOKUMPU IH,KAIRALUOMA MI,NUORVA KP,et al.Short and long term outcome following laparoscopic versus open resection for carcinoma of the rectum in the multimodal setting[J].Dis Colon Rectum,2012,55(8):854-863.
[5]宗亮,陈平,赵伟,等.国内腹腔镜与开腹结直肠癌手术治疗术后并发症的Meta分析[J].中华临床医师杂志:电子版,2012,6(3):648-652.
[6]胡辉,荆绪斌,严江,等.腹腔镜与结肠镜联合诊治大肠病变的应用[J].中华临床医师杂志:电子版,2011,5(11):3343-3344.
[7]傅骏,郁宝铭,卞国伟,等.纳米碳标记在结直肠癌根治术中的应用[J].结直肠肛门外科,2009,15:160-162.
[8]史衍辉,夏璐,南林,等.纳米碳引导下腹腔镜中低位直肠癌根治术的近期疗效分析[J].中华临床医师杂志:电子版,2012,6(21):6682-6684.
[9]颜博,葛洁,张斌,等.纳米碳在乳腺癌前哨淋巴结活检中的临床应用[J].中国肿瘤临床,2011,38(21):1335-1337.
[10]夏旭,刘伟,欧勇,等.纳米碳引导下腹腔镜中低位直肠癌根治术24例临床观察[J].中国临床研究,2015,28(6):776-778.
[11]赵纲,童汉兴,刘凤林,等.纳米碳在腹腔镜中低位直肠癌根治术中的应用价值[J].中华实验外科杂志,2009,23(26):1204-1206.
[12]张相春.纳米碳淋巴示踪剂在腹腔镜结直肠癌手术中的应用以及前哨淋巴结活检的临床意义[D].山东大学,2015.
[13]李坚,张阳德,龚连生,等.侧方淋巴结清扫在低位直肠癌根治术中的应用[J].中华临床医师杂志:电子版,2011,5(11):3141-3145.
[14]田相安,杨成菊,丁元升,等.纳米炭导航腹腔镜中低位直肠癌根治术个体化淋巴结清除的临床研究[J].中国现代普通外科进展,2017,20(3):188-192.
[15]林周,俞宪明,黄敏娴,等.纳米碳染色在直肠癌侧方淋巴结清扫中的应用研究[J].实用临床医药杂志,2010,14(9):50-51.
[16]陈涛,华一兵.纳米碳和亚甲蓝在结直肠癌根治术淋巴结检出中的应用[J].临床和实验医学杂志,2016,15(24):2410-2414.
[17]茅慧,千年松,周艳华,等.白介素17与结直肠癌[J].现代生物医学进展,2016,16(19):3776-3778.
[18]王建升.Th17/Treg细胞及相关细胞因子在结直肠癌发展过程中的变化[D].首都医科大学,2012.
[19]戚红霞,李晓虹,胡海强.血清IGF-1、IGFBP-3、VEGF及多项白介素在结直肠癌转移监测中的意义[J].海南医学院学报,2013,19(2):176-179.
[20]庄佳娥,庄柏润,包冕,等.直肠癌行腹腔镜与开放术后感染致病菌分析与干扰素、白介素水平观察[J].中国医药科学,2017,7(14):11-14.