完整结肠系膜切除术治疗老年结肠癌的临床疗效及对患者血清CRP、TNF-α和IL-6水平的影响

摘要

Objective To discuss the impact of serum CRP, TNF-α and IL-6 in patients with old colon carcinoma accepted with complete mesocolic excision. Methods 72 patients with old colon carcinoma from June 2014 to January 2016 in our hospital were retrospectively analysis, 36 patients of them accepted with traditional radical resection were taken as control group, the other 36 patients accepted with complete mesocolic excision were taken as research group. Recorded the operation related indexs, compared the number of cleared lymph node, observed the occurrence of complications and neoplasm recurrence in two group. Detected the levels of serum CRP, TNF-α and IL-6 preoperative 1 d and postoperative 1 d, 3 d. Results The intraoperatve blood soss, anus exhausting time, removal time, start eating time after surgery and hospitals stays were lower than that in control group, differences were statisticall significance (P ＜ 0.05). The number of eradication of average lymph node, positive transfer of lymph nodes, left half colon lymph nodes and righ half colon lymph nodes in research group were more than that in control group, differences were statisticall significance (P ＜ 0.05). The levels of serum CRP, TNF-α and IL-6 postoperative 1 d, 3 d in research group were lower than that in control group, differences were statisticall significance (P ＜ 0.05). Conclusion Complete mesocolon resection to treat senile colonic cancer, which can effectively improve the number of lymph node excision, reduce the incidence of postoperative complications and the recurrence rate, at the same time it has a small surgical trauma, less intraoperative blood loss and the body's stress response and other advantages, is worth for clinical application.%目的 探讨完整结肠系膜切除术治疗老年结肠癌的临床疗效及对患者血清CRP、TNF-α和IL-6水平的影响.方法 回顾性分析72例结肠癌患者的临床资料,根据治疗方式的不同,分为对照组和研究组,各36例.对照组患者接受传统根治术治疗,而研究组患者则接受完整结肠系膜切除术治疗.记录2组患者手术相关指标,对比分析2组患者术中淋巴结清除情况,观察2组患者术后并发症的发生情况和肿瘤复发情况.并于术前1 d和术后1、3 d检测2组患者血清CRP、TNF-α和IL-6水平的变化.结果 研究组患者的术中出血量、肛门排气时间、拔管时间、术后开始进食时间和住院时间均低于对照组,2组间差异有统计学意义 (P ＜0.05);研究组患者平均淋巴结、阳性转移淋巴结、左半结肠淋巴结和右半结肠淋巴结的清除数目均高于对照组,差异有统计学意义 (P ＜0.05).研究组患者手术后1、3 d血清CRP、TNF-α和IL-6水平均明显低于对照组,差异有统计学意义 (P ＜0.05).研究组患者的术后并发症发生率和复发率均低于对照组,差异有统计学意义 (P ＜0.05).结论 完整结肠系膜切除术治疗老年结肠癌,可有效提高淋巴结的切除数目,降低术后并发症发生率和复发率,同时具有手术创伤小、术中出血量少、机体应激反应轻等优点,值得应用于临床.