术中腹内压增加对大肠癌微创手术患者消化系统影响的研究

发布时间：2018-04-05 18:54

本文选题：腹内压　切入点：大肠癌　出处：《中国内镜杂志》2017年02期

【摘要】：目的探究术中腹内压增加对大肠癌微创手术患者消化系统的影响。方法回顾性分析2013年1月-2016年6月该院收治的132例经腹腔镜大肠癌根治手术治疗的大肠癌患者的临床资料。根据患者术中采用的腹内压将患者分为A组、B组和C组。A组46例患者为10 mm Hg(1 mm Hg=0.133 k Pa),B组45例患者为12 mm Hg,C组41例患者为15 mm Hg。比较3组患者术后各项恢复时间、并发症情况和血清细胞因子水平。结果 3组患者术后6 h内拔出鼻胃管例数、肠蠕动恢复时间、首次肛门排气或排便时间、耐受半流质饮食时间、术后腹泻持续时间和术后住院时间差异均无统计学意义(P0.05)。术后3组患者急性胃肠损伤(AGI)、乳糜漏、吻合口瘘、术区渗血、肠麻痹和术后呕吐发生率差异均无统计学意义(P0.05)。术后3组患者的白细胞介素-6(IL-6)和平均动脉压(MAP)较术前均明显升高,差异有统计学意义(P0.05)。术前3组患者的肿瘤坏死因子-α(TNF-α)较术后差异无统计学意义(P0.05)。术后25例肠麻痹患者血清IL-6水平为(10.71±4.37)ng/L,107例未发生肠麻痹患者的血清IL-6水平为(10.66±4.13)ng/L,差异无统计学意义(P0.05)。结论术中腹内压增加对大肠癌微创手术患者消化系统没有显著影响。
[Abstract]:Objective to investigate the effect of intraoperative abdominal pressure increase on digestive system in patients with colorectal cancer undergoing minimally invasive surgery.Methods the clinical data of 132 patients with colorectal cancer treated by laparoscopic radical resection of colorectal cancer from January 2013 to June 2016 were retrospectively analyzed.According to the intraabdominal pressure, the patients were divided into two groups: group A (n = 46) and group C (n = 46): 10 mm Hg(1 mm Hg=0.133 (n = 45), group B (n = 45), and group C (n = 41): 15mm Hg.The recovery time, complications and serum cytokine levels were compared among the three groups.Results there were no significant differences in the number of cases, the recovery time of intestinal peristalsis, the time of first anal exhaust or defecation, the time of tolerance to hemi-fluid diet, the duration of postoperative diarrhea and the postoperative hospital stay in the three groups within 6 hours after operation (P 0.05).There was no significant difference in the incidence of acute gastrointestinal injury such as agi, chylous leakage, anastomotic leakage, blood leakage, intestinal palsy and postoperative vomiting in the three groups after operation (P 0.05).The levels of interleukin-6 (IL-6) and mean arterial pressure (MAPP) in the three groups were significantly higher than those before operation (P 0.05).There was no significant difference in tumor necrosis factor- 伪 and TNF- 伪 between the three groups before and after operation (P 0.05).The serum IL-6 level of 25 patients with intestinal palsy was 10.71 卤4.37 ng / L, and the serum IL-6 level was 10.66 卤4.13 ng / L in 107 patients without intestinal palsy. The difference was not statistically significant (P 0.05).Conclusion the increase of intraabdominal pressure has no significant effect on the digestive system of patients with colorectal cancer undergoing minimally invasive surgery.
【作者单位】：浙江大学医学院附属第二医院长兴分院(长兴县人民医院)普外科;
【分类号】：R735.34

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