腹腔镜与开腹结直肠癌根治术对原发性高血压患者心肺功能影响的前瞻性对照研究
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江苏省第五批次“六大人才高峰”项目资助


Cardiopulmonary functions in laparoscopic versus open surgery for colorectal carcinoma complicated with primary hypertension:a prospective controlled study
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    摘要:

    目的:探讨腹腔镜与开腹结直肠癌根治术对结直肠癌合并原发性高血压患者心肺功能影响的差异-方法:前瞻性分析2008年5月~2010年7月南京医科大学第二附属医院胃肠外科收治的205例结直肠癌患者的临床资料-采用抽签法将患者分成腹腔镜组(laparoscopic operation,LO组)和开腹组(conventional operation,CO组),其中4例自动退出试验,1例腹腔镜组患者中转开腹剔除本实验,最终102例纳入腹腔镜组,98例纳入开腹组-观察指标包括术前1 d-术中-术后1 d心率(HR)-收缩压(SBP)-舒张压(DBP)-血气分析结果及术前1 d-术后1 d用力肺活量(FVC)及第1秒用力呼气容积(FEV1)-结果:腹腔镜组术中SBP(130.8±7.7) mmHg(1 mmHg = 0.133 kPa),开腹组(128.1 ± 10.5) mmHg(P = 0.039);术前1 d及术后1 d两组无差异;术前1 d,两组肺功能无差异,术后1 d腹腔镜组FVC(2.03 ± 0.35)l,开腹组(1.87 ± 0.23)l (P = 0.001)-结论:在达到同等根治切除清扫程度下,腹腔镜下结肠根治术比开腹手术对结直肠癌合并高血压患者心肺功能的影响要小-

    Abstract:

    Objective:To assess the differences in cardiopulmonary functions between laparoscopic and open surgery for colorectal carcinoma complicated with primary hypertension. Methods: The clinical data of 205 patients with colorectal carcinoma complicated with primary hypertension between May 2008 and July 2010 in the Second Affiliated Hospital of NJMU were prospectively analyzed. Of all the patients,200 cases were finally included in the study,and were randomly allocated to laparoscope group (n = 102) and conventional operation group(n = 98). The HR,SBP,DBP and the results of blood gas analysis of patients at 1st day before operation,interoperation,1st day after operation were recorded,pulmonary function on the 1st day before and after operation was analyzed as well. Results: The SBP,DBP and PaCO2 during interoperation increased significantly in the laparoscopic group than that in the conventional operation group. But on 1st day before operation and 1st day after operation,the results were not different between the two groups. Pulmonary function is better preserved after laparoscopic operation than that after conventional operation on the 1st day after operation. Conclusion: With equal degree of radical resection,laparoscopic technique for colorectal carcinoma complicated with primary hypertension causes less cardiopulmonary function injury as compared with conventional operation.

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刘 翔,何震宇,汪宝林,张建平,赵庆洪,闻 浩.腹腔镜与开腹结直肠癌根治术对原发性高血压患者心肺功能影响的前瞻性对照研究[J].南京医科大学学报(自然科学版),2012,(4):528-531

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  • 收稿日期:2011-12-11
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