結(jié)腸鏡結(jié)合腹腔鏡行早期結(jié)腸癌根治術(shù)對患者胃腸功能及免疫功能的影響

胡學(xué)升 李曉霞 李建光 陳福佳 王金重

[摘要] 目的 將結(jié)腸鏡結(jié)合腹腔鏡用于結(jié)腸癌患者治療中，分析其對患者胃腸功能及免疫功能的影響。 方法 選取2014年5月至2017年8月收治的92例結(jié)腸癌患者進行分組研究，隨機分成觀察組（n=46）與對照組（n=46），對照組行傳統(tǒng)開腹手術(shù)治療，觀察組行結(jié)腸鏡結(jié)合腹腔鏡結(jié)腸癌根治術(shù)，對兩組手術(shù)及術(shù)后胃腸功能恢復(fù)、免疫功能、并發(fā)癥發(fā)生率進行比較。 結(jié)果 觀察組下床活動時間、肛門排氣時間、進流食時間分別為（2.71±0.71）d、（2.23±0.56）d、（2.45±0.58）d，短于對照組（3.52±0.85）d、（3.24±0.63）d、（3.36±0.75）d，兩組差異有統(tǒng)計學(xué)意義（P<0.05）;觀察組術(shù)后CD3+、CD4+、CD4+/CD8+水平為（56.15±7.32）%、（48.69±7.25）%、（1.96±0.25）%，高于對照組（34.95±6.31）%、（36.12±6.32）%、（1.45±0.15）%，兩組差異有統(tǒng)計學(xué)意義（P<0.05）;觀察組術(shù)后并發(fā)癥率為4.34%，低于對照組的19.57%，兩組差異有統(tǒng)計學(xué)意義（P<0.05）。 結(jié)論 對結(jié)腸癌患者而言，于結(jié)腸鏡結(jié)合腹腔鏡下行結(jié)腸癌根治術(shù)效果理想，可促進患者胃腸功能盡快恢復(fù)，對患者免疫功能影響較小，且并發(fā)癥較少，值得應(yīng)用。

[關(guān)鍵詞] 結(jié)腸鏡;腹腔鏡;結(jié)腸癌根治術(shù);胃腸功能;免疫功能

[中圖分類號] R735.35? ? ? ? ? [文獻標識碼] B? ? ? ? ? [文章編號] 1673-9701（2021）24-0062-04

Effects of colonoscopy combined with laparoscopy on gastrointestinal function and immune function of patients undergoing radical resection of early colon cancer

HU Xuesheng? ?LI Xiaoxia? ?LI Jianguang? ?CHEN Fujia? ?WANG Jinzhong

Department of General Surgery， Jiangmen People's Hospital in Guangdong Province， Jiangmen? ?529000， China

[Abstract] Objective To apply the colonoscopy combined with laparoscopy in the treatment of patients with colon cancer， and analyze its effects on gastrointestinal function and immune function of patients. Methods A total of 92 patients with colon cancer who were admitted from May 2014 to August 2017 were randomly divided into two groups： the observation group （n=46） and the control group （n=46）. The control group was given traditional open surgery， and the observation group was given colonoscopy combined with laparoscopic radical resection of colon cancer. The recovery of gastrointestinal functions， immune functions and the incidences of complications during and after surgery were compared between the two groups. Results The time of getting out of bed， anal exhaust and fluid feeding in the observation group were （2.71±0.71） d， （2.23±0.56） d and （2.45±0.58） d， respectively， which were shorter than those in the control group， （3.52±0.85） d， （3.24±0.63） d and （3.36±0.75） d， and the differences between the two groups were statistically significant （P<0.05）. The levels of CD3+， CD4+， CD4+/CD8+ in the observation group were （56.15±7.32） %， （48.69±7.25） % and （1.96±0.25） %， respectively， which were higher than the those in the control group， （34.95±6.31） %， （36.12±6.32） % and （1.45±0.15） %， and the differences between the two groups were statistically significant（P<0.05）. The rate of postoperative complications in the observation group was 4.34%， which was lower than 19.57% in the control group， and the difference between the two groups was statistically significant（P<0.05）. Conclusion For patients with colon cancer， colonoscopy combined with laparoscopy for radical resection of colon cancer has an ideal effect， which can promote the recovery of gastrointestinal function as soon as possible， has little impact on the immune function of patients， and has fewer complications， which is worthy of application.