腹腔镜结肠癌根治术对老年患者炎性因子水平及预后的影响分析

摘要

Objective To investigate the effect of laparoscopic radical resection of colon cancer in the treatment of postoperative inflammatory factors and prognosis in elderly patients with colon cancer. Method 120 cases of elderly patients with colon cancer were randomly divided into observation group and control group, 60 cases in each group. Control group patients were treated with traditional open surgery, observation group patients were treated with laparoscopic radical resection of colon cancer. Observed two groups of patients with operation index and incidence of postoperative complications, preoperative and postoperative 7 days of tumor necrosis factor-α(TNF-α), interleukin (IL)-17 level, after 2 years of follow-up, observed the recurrence and survival rates between the two groups. Result The intraoperative blood loss of observation group were lower than control group postoperative exhaust time, postoperative ambulation time, operation time and hospitalization time were less than control group (P 0.05);7 days after operation in two groups of patients with serum TNF-αand IL-17 levels were significantly higher than before operation (P0.05). Conclusion The effect of laparoscopic colon cancer radical operation in the treatment of elderly patients with colon cancer is obvious,and the influence of postoperative inflammatory factors is small, the prognosis is good, it has important significance.%目的：探讨腹腔镜结肠癌根治术对老年患者炎性因子水平及预后的影响。方法将本院2013年6月至2014年6月收治的120例老年结肠癌患者按照随机数表法分为观察组与对照组，每组各60例。对照组患者行传统开腹结肠癌根治术，观察组患者行腹腔镜结肠癌根治术。观察两组患者手术情况、术后并发症发生率及术前和术后7天肿瘤坏死因子-α（tumor necrosis factor-α，TNF-α）、白介素（interleukin，IL）-17水平变化。所有患者均于术后随访2年，观察两组患者复发及生存情况。结果观察组患者术中出血量多于对照组（P＜0.05），术后排气时间、术后下床活动时间、手术时间及住院时间均短于对照组（P＜0.05），切口长度小于对照组（P＜0.05）。观察组患者术后总并发症发生率[6.67%（4/60）]显著低于对照组[28.33%（17/60）]（P＜0.05）。术前两组患者血清TNF-α和IL-17水平比较差异均无显著性（P＞0.05）；术后7天两组患者血清TNF-α和IL-17水平较术前均显著升高（P＜0.05），观察组患者血清TNF-α和IL-17水平均显著低于对照组（P＜0.05）。观察组患者复发率显著低于对照组（P＜0.05），生存率显著高于对照组（P＞0.05）。结论腹腔镜结肠癌根治术治疗老年结肠癌效果显著，对患者术后炎性因子水平影响小，且预后良好。