【摘要】 目的分析腹腔镜直肠癌切除术患者血清异常凝血酶原、前白蛋白水平变化及临床意义。方法前瞻性选取2015年9月至2020年9月肇庆市第一人民医院住院治疗的100例直肠癌患者,以单盲随机抽样法分为2组,每组各50例。对照组采用传统开腹手术治疗,实验组采用腹腔镜直肠癌切除术治疗。比较2组患者手术指标,术前和术后3 d血清凝血酶原、前白蛋白水平以及并发症发生率。结果实验组与对照组淋巴结清扫数目比较[(14.26±3.62)个vs.(14.33±3.52)个],差异无统计学意义(P> 0.05)。实验组术中出血量(120.26±15.92) mL低于对照组的(208.26±34.17) mL,实验组手术时间、切口长度、首次排气时间、首次排便时间、首次下床时间、住院时间分别为(121.26±15.62)min、(5.16±0.62) cm、(2.52±0.16) d、(3.03±0.16) d、(3.26±0.16) d、(12.26±1.84) d,均短于对照组[(149.62±21.62) min、(14.36±1.62) cm、(4.92±0.34) d、(4.92±0.66) d、(5.28±0.94) d、(18.62±3.64) d],差异均有统计学意义(P <0.05)。2组患者术前血清凝血酶原、前白蛋白水平比较[(11.62±1.62) s vs.(11.59±1.59) s、(172.26±12.62) mg/L vs.(173.16±12.55) mg/L],差异无统计学意义(P> 0.05);实验组术后3 d血清凝血酶原、前白蛋白分别为(11.26±1.62) s、(168.26±10.16) mg/L,均高于对照组[(9.83±1.04) s、(128.26±9.32) mg/L],差异均有统计学意义(P <0.05)。实验组并发症发生率(4.00%)低于对照组(22.00%),差异有统计学意义(P <0.05)。结论腹腔镜直肠癌切除术治疗直肠癌对患者凝血酶原、前白蛋白影响较小,且治疗时间较短,并发症较少,患者预后良好,值得借鉴。更多还原

【Abstract】 Objective To analyze the changes and clinical significance of abnormal prothrombin and prealbumin levels in serum of patients with laparoscopic rectal cancer resection. Methods From September 2015 to September 2020,100 patients with rectal cancer hospitalized in the First People’s Hospital of Zhaoqing City were prospectively selected and divided into 2 groups according to single-blind random sampling method,50 cases in each group. The control group was treated with traditional open surgery,and the experimental group was treated with laparoscopic rectal cancer resection. Surgical indicators,serum prothrombin,prealbumin levels before and 3 days after surgery and complication rates of the two groups of patients were compared. Results Comparison of the number of lymph node dissection between the experimental group and the control group [ (14. 26 ± 3. 62) vs. (14. 33 ± 3. 52) ],the difference was not statistically significant (P > 0. 05). The intraoperative blood loss (120. 26 ± 15. 92) mL of the experimental group was lower than that of the control group (208. 26 ± 34. 17) mL,the operation time,incision length,first exhaust time,first defecation time,first time to get out of bed,and hospital stay in the experimental group were (121. 26 ± 15. 62)min, (5. 16 ± 0. 62) cm, (2. 52 ± 0. 16) d, (3. 03 ± 0. 16) d, (3. 26 ± 0. 16) d, (12. 26 ± 1. 84) d,respectively,all shorter than the control group[ (149. 62 ± 21. 62) min, (14. 36 ± 1. 62) cm, (4. 92 ± 0. 34) d, (4. 92 ± 0. 66) d, (5. 28 ± 0. 94) d, (18. 62 ± 3. 64) d],the difference was statistically significant (P < 0. 05). Comparison of preoperative serum prothrombin and prealbumin levels in the two groups [ (11. 62 ±1. 62) s vs. (11. 59 ± 1. 59) s, (172. 26 ± 12. 62) mg/L vs. (173. 16 ± 12. 55) mg/L],the difference was not statistically significant (P >0. 05); serum prothrombin and prealbumin in the experimental group were (11. 26 ± 1. 62) s and (168. 26 ± 10. 16) mg/L at 3 days postoperatively,which were higher than those of the control group[ (9. 83 ± 1. 04) s, (128. 26 ± 9. 32) mg/L],the differences were statistically significant (P < 0. 05). The incidence of complications in the experimental group (4. 00%) was lower than that in the control group (22. 00%),and the difference was statistically significant (P < 0. 05). Conclusion Laparoscopic resection of rectal cancer has little effect on prothrombin and proalbumin in patients with rectal cancer,and the treatment time is short,with fewer complications,and the prognosis of the patients is good,which is worthy of reference.更多还原