经肛门显微手术治疗直肠肿瘤的临床疗效及对血清IL-2 IL-6 TNF-α水平的影响

doi:10.3969/j.issn.1006-6233.2018.08.016

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摘要 目的: 探讨经肛门显微手术治疗直肠肿瘤的临床疗效及对血清白介素IL-2、IL-6、肿瘤坏死因子(TNF)-α水平的影响。 方法: 回顾性分析我院2014年2月至2015年12月接诊的68例直肠肿瘤患者,通过手术方式不同分为2组,每组34例,对照组使用传统直肠癌根治切除术(Miles手术)治疗,观察组使用经肛门显微手术治疗。比较两组围术期情况,术前术后肛门直肠功能评分、血清IL-2、IL-6、TNF-α水平的变化及术后并发症的发生情况。 结果: 观察组手术时间、肛门排气时间、进食时间、住院时间均明显短于对照组,术中出血量显著少于对照组(P<0.05)。手术后,观察组肛门直肠功能评分、血清IL-6、TNF-α水平均明显低于对照组(P<0.05),血清IL-2水平明显高于对照组(P<0.05),尿道损伤、感染、吻合口瘘、大便失禁的总发生率明显低于对照组(P<0.05)。 结论: 应用经肛门显微手术治疗直肠肿瘤患者的临床效果显著,有助于促进术后恢复,且对血清IL-2、IL-6、TNF-α的影响较小,安全性高,值得应用推广。

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关键词 ：直肠肿瘤, 经肛门显微手术, 直肠癌根治术, 肛门直肠功能, 细胞因子

Abstract：Objective: To study the clinical efficacy of transanal microsurgery in the treatment of rectal tumor and its effects on the serum IL-2, IL-6 and TNF-α levels. Methods: A retrospective analysis of 68 cases of rectal cancer admitted from February 2014 to December 2015 in our hospital was carried out. The patients were divided into 2 groups by operation method, 34 cases in each group. The control group was treated with traditional rectal cancer radical resection (Miles operation), while the observation group was treated with transanal microsurgery. The perioperative condition, preoperative anorectal function score, serum IL-2, IL-6 and TNF- alpha levels and postoperative complications of the two groups were compared. Results: The operation time, anal exhaust time, feeding time, hospitalization time of observation group were significantly shorter than those of the control group, the amount of bleeding was significantly less than that of the control group (P<0.05). After surgery, the anorectal function score of observation group was significantly lower than that of the control group (P<0.05), the serum IL-2 level of observation group was significantly higher than that of the control group, and the serum IL-6 and TNF-α levels were significantly lower than those of the control group (P<0.05); the total incidence of urethral injury, infection, anastomotic leakage and encopresis of observation group was significantly lower than that of the control group(P<0.05). Conclusion: The application of transanal microsurgery in the treatment of rectal tumor patients is significant. It can help to promote postoperative recovery, and has less effect on serum IL-2, IL-6, TNF- a, and is safe and worthy of application.

Key words： Rectal tumor Transanal microsurgery Radical resection of rectal cancer Anorectal function Cell factor

基金资助:河北省自然科学基金项目,(编号:C2008001116)

引用本文:

姚远, 李青科, 马国明, 王雅琪, 王宇, 徐卫国. 经肛门显微手术治疗直肠肿瘤的临床疗效及对血清IL-2 IL-6 TNF-α水平的影响[J]. 河北医学, 2018, 24(8): 1293-1296.
YAO Yuan, LI Qingke, MA Guoming, et al. Clinical Efficacy of Transanal Microsurgery in the Treatment of Rectal Tumor and Its Effects on Serum IL-2 IL-6 and TNF-α Levels. HeBei Med, 2018, 24(8): 1293-1296.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2018.08.016 或 http://www.hbyxzzs.cn/CN/Y2018/V24/I8/1293

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