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目的比较腹腔镜与开腹根治术术后直肠癌患者感染率及对炎症因子的影响,为临床治疗提供依据。方法选取2012年8月-2015年8月医院收治的直肠癌患者138例,根据治疗时间不同将其分为腹腔镜组76例与开腹组62例;腹腔镜组采用腹腔镜直肠癌根治术治疗,开腹组采用开腹直肠癌根治术治疗,术后观察两组患者感染发生情况,并对两组治疗前后炎症因子变化进行比较。结果腹腔镜组术后感染率为2.62%,开腹组术后感染率为11.29%,两组间比较差异有统计学意义(P<0.05);手术前,腹腔镜组与开腹组血清C-反应蛋白(CRP)、白介素6(IL-6)及肿瘤坏死因子-α(TNF-α)水平相当,比较差异无统计学意义;与开腹组比较,腹腔镜组患者术后1、3、5d血清CRP、IL-6水平明显降低,TNF-α水平明显升高,差异有统计学意义(P<0.05)。结论与开腹直肠癌根治术相比,腹腔镜直肠癌根治术术后患者感染率更低,对机体炎症因子的影响更小,且无严重并发症,值得临床推广应用。
Objective To compare the infection rate of rectal cancer patients after laparoscopic and radical mastectomy and the influence on inflammatory cytokines in order to provide basis for clinical treatment. Methods A total of 138 patients with rectal cancer who were admitted to our hospital from August 2012 to August 2015 were divided into two groups: 76 cases in laparoscopic group and 62 cases in open group according to different treatment time. Laparoscopic radical resection of rectal cancer The patients in laparotomy group were treated with open rectal cancer radical mastectomy. The incidence of infection in the two groups was observed after operation. The changes of inflammatory cytokines in both groups were compared before and after treatment. Results The postoperative infection rate in laparoscopic group was 2.62%, the postoperative infection rate in laparotomy group was 11.29%, there was significant difference between the two groups (P <0.05). Before operation, serum C (CRP), interleukin 6 (IL-6) and tumor necrosis factor-α (TNF-α) were significantly higher in the laparoscopic group than those in the laparoscopic group (P <0.05). Serum levels of CRP and IL-6 were significantly decreased and TNF-α levels were significantly increased on the 5th day (P <0.05). Conclusion Compared with open radical resection of rectal cancer, laparoscopic radical resection of rectal cancer patients with lower infection rates, the impact on the body inflammatory factors smaller, and no serious complications, worthy of clinical application.