内质网应激在结肠癌术后并发腹腔感染中的作用机制及其对肠道护理的启示

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目的:探讨结肠癌术后并发腹腔感染的内质网应激机制及其对肠道护理的启示.方法:采用蛋白免疫印迹检测体外培养人肠上皮Caco-2细胞株中内质网应激相关蛋白转录因子C/EBP同源蛋白(C/EBP homologous protein,CHOP)的表达;实时荧光定量聚合酶链式反应检测肠道紧密连接蛋白膜周蛋白(zonula occludens,ZO)信使核糖核酸(messenger Ribonucleic Acid,mRNA)的表达水平;选取2017年10月—2020年10月在南京医科大学附属南京医院普外科诊治的56例结肠癌术后并发腹腔感染的病人为研究对象,观察组28例,给予基于循证支持的氧气吸入术和局部氧疗为主的护理干预;对照组28例,给予常规护理干预.检测两组病人血清C反应蛋白(CRP)、肿瘤坏死因子α(TNF-α)、白介素6(IL-6)水平,观察两组并发症、焦虑、抑郁发生率及护理满意度.结果:常氧条件下,体外培养的Caco-2细胞中ZO-1及CHOP的表达与缺氧条件下表达进行比较,差异有统计学意义(均P<0.05或P<0.01);护理干预后,观察组CRP、TNF-α和IL-6与对照组比较,差异均有统计学意义(均P<0.001);腹腔感染、肠梗阻、吻合口漏和并发症总发生率与对照组比较,差异有统计学意义(均P<0.05);焦虑、抑郁发生率及护理满意度与对照组比较,差异具有统计学意义(P<0.05).结论:基于循证支持的护理干预有助于减少结肠癌术后并发腹腔感染病人的并发症,缓解焦虑、抑郁等负性情绪.
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