腹腔镜结肠癌根治术联合术后洛铂腹腔热灌注化疗对结肠癌患者全身各系统的影响

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摘要目的探讨腹腔镜结肠癌根治术联合洛铂腹腔热灌注化疗对结肠癌患者术后血常规、肝功能、肾功能及术后并发症的影响。方法回顾性选取肇庆市第一人民医院2018年1月至2021年1月收治的100 例结肠癌患者作为研究对象。将腹腔镜结肠癌根治术联合洛铂腹腔热灌注化疗的患者设置为观察组，将采用单纯腹腔镜结肠癌根治术的患者设置为对照组，每组各50 例。比较两组患者术前及术后第3、5 天的血常规、肝功能、肾功能、免疫感染指标及术后恢复排气排便时间、进食时间、住院时间、并发症发生率等情况。结果术前，术后3、5 d，两组患者的白细胞（WBC）、血红蛋白（HGB）、血小板（PLT）比较，差异无统计学意义（P＞0.05）；两组患者术后3、5 d 的WBC、PLT 高于术前，HGB 低于术前，差异有统计学意义（P＜0.05）。术前，术后3、5 d，两组患者的丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）比较，差异无统计学意义（P＞0.05）；两组患者术后3 d 的AST 及术后5 d 的ALT 与本组术前比较，差异无统计学意义（P＞0.05）；两组患者术后3 d 的ALT 及术后5 d 的AST 高于本组术前，差异有统计学意义（P＜0.05）。术前，术后3、5 d，两组患者的尿素（BUN）、血清肌酐（SCr）比较，差异无统计学意义（P＞0.05）；两组患者术后3、5 d 的BUN、SCr 与术前比较，差异无统计学意义（P＞0.05）。术前，术后5 d，两组患者的C-反应蛋白（CRP）比较，差异无统计学意义（P＞0.05）；术后3 d，观察组的CRP 高于对照组，差异有统计学意义（P＜0.05）；两组患者术后3、5 d 的CRP 均高于本组术前，差异有统计学意义（P＜0.05）。观察组恢复排气排便、进食时间长于对照组，差异有统计学意义（P＜0.05）。两组患者总住院时间比较，差异无统计学意义（P＞0.05）。两组患者术后并发症及术后1月再住院例数比较，差异无统计学意义（P＞0.05）。结论腹腔镜结肠癌根治术联合洛铂腹腔热灌注化疗治疗结肠癌患者安全可行，术后对患者的血液系统、肝功能、肾功能影响甚微，对胃肠道功能有影响，但并不会提高术后并发症发生率。

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关键词 ：腹腔镜结肠癌根治术, 围手术期, 腹腔热灌注化疗, 洛铂, 疗效, 并发症

Abstract：Objective To investigate the effect of laparoscopic radical resection of colon cancer combined with intraperitoneal hyperthermic perfusion chemotherapy of Lobaplatin on the safety of postoperative blood routine,liver function,renal function,and postoperative complications in patients with colon cancer.Methods A total of 100 patients with colon cancer admitted to the First People′s Hospital of Zhaoqing from January 2018 to January 2021 were retrospectively selected as the research objects.The patients who underwent laparoscopic radical colon cancer surgery combined with intraperitoneal hyperthermic perfusion chemotherapy with Lobaplatin were set as the observation group,and the patients who underwent laparoscopic radical colon cancer surgery alone were set as the control group,with 50 cases in each group.The blood routine,liver function,renal function,immune infection indexes,and postoperative recovery time of exhausting and defecation,food taking,hospital stay,and complication rate were compared between the two groups before and at 3 and 5 d after operation.Results Before operation and 3,5 d after operation,there were no significant differences in the levels of white blood cell(WBC),hemoglobin(HGB)or platelet(PLT)between the two groups(P＞0.05).At 3 and 5 d after operation,the levels of WBC and PLT of the two groups were higher than those before operation,and the HGB was lower than that before operation,with statistical significance(P＜0.05).Before operation and 3,5 d after operation,there were no significant differences in the level of alanine aminotransferase(ALT)or aspartate aminotransferase(AST)between the two groups(P＞0.05).There were no significant differences in AST at 3 d after operation and ALT at 5 d after operation in the two groups compared with those before operation(P＞0.05).The ALT at 3 d after operation and AST at 5 d after operation in the two groups were higher than those before operation,the differences were statistically significant(P＜0.05).Before operation and 3,5 d after operation,there was no significant difference in blood urea nitrogen(BUN)or serum creatinine(SCr)between the two groups(P＞0.05).There was no significant difference in the BUN or SCr of the two groups at 3 and 5 d after operation compared with those before operation(P＞0.05).Before operation and 5 d after operation,there was no significant difference in C-reactive protein(CRP)between the two groups(P＞0.05).Compared with the control group,the CRP in the observation group was higher than the control group at 3 d after operation,and the difference was statistically significant(P＜0.05).The CRP of the two groups at 3 and 5 d after the operation was higher than that before the operation,and the difference was statistically significant(P＜0.05).The recovery time of exhausting and defecation as well as taking food in observation group was longer than those in the control group,and the differences were statistically significant(P＜0.05).There were no significant differences between the two groups in postoperative complications and the number of rehospitalization one month after operation(P＞0.05).Conclusion Laparoscopic radical resection of colon cancer combined with Lobaplatin intraperitoneal hyperthermic perfusion chemotherapy is safe and feasible in the treatment of patients with colon cancer.It has litter influence on the blood system,liver function,and renal function,but did have effect on gastrointestinal system.It will not increase the incidence of postoperative complications.

Key words： Laparoscopic radical resection of colon cancer Perioperative period Intraperitoneal hyperthermic perfusion chemotherapy Lobaplatin Efficacy Complications

收稿日期: 2021-11-19

基金资助:广东省肇庆市科技计划项目（2021040308022）

作者简介: 张楠（1985-），男，广东罗定人，硕士，研究方向：胃肠肛肠外科

引用本文:

张楠；区基文；张清. 腹腔镜结肠癌根治术联合术后洛铂腹腔热灌注化疗对结肠癌患者全身各系统的影响[J]. 中国当代医药, 2022, 29(11): 7-11.
ZHANG Nan OU Jiwen ZHANG Qing. Influence of laparoscopic radical resection of colon cancer combined with postoperative intraperitoneal hyperthermic perfusion chemotherapy with Lobaplatin on different systems in patients with colon cancer. 中国当代医药, 2022, 29(11): 7-11.

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https://www.dangdaiyiyao.com/CN/ 或 https://www.dangdaiyiyao.com/CN/Y2022/V29/I11/7

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