腹腔镜微创对直肠癌患者肛肠动力学及血清CEA, CA724水平的影响

目的:探讨腹腔镜微创对直肠癌患者肛肠动力学及血清癌胚抗原(CEA)、糖链抗原724(CA724)水平的影响。方法:选择2014年3月~2016年3月38例直肠癌患者为研究组及同期40例非肿瘤性肠息肉患者为对照组,比较术前两组的肛肠动力学指标(肛管静息压(ARP)、直肠静息压(RRP)、肛管最大收缩压(MSP)、直肠最大耐受容量(MTV),检测研究组术前及术后3 d、1、2周血清CEA、CA724水平,并观察临床疗效。结果:研究组术前ARP、RRP、MSP、MTV与对照组比较无明显差异(P0.05),术后2、4周均明显降低(P0.05),之后逐渐恢复,并在术后12周基本恢复至术前水平。研究组术后3 d血清CEA、CA724水平与术前比较无明显差异(P0.05),术后1、2周均明显低于术前(P0.05)。临床有效率为65.8%。结论:腹腔镜微创治疗直肠癌的疗效确切,可有效降低肿瘤标志物水平,虽对肛肠动力学有一定的影响,但可在短期内恢复正常。

Effect of Laparoscopic Minimally Invasive on Anorectal Dynamics and Serum CEA and CA724 in Patients with Rectal Cancer

ABSTRACT Objective: To explore the effect of laparoscopic minimally invasive on anorectal dynamics and serum carcino-embryonic antigen (CEA) and carbohydrate antigen 724 (CA724) in patients with rectal cancer. Methods: 38 cases of rectal cancer patients were selected as the research group from March 2014 to March 2016 and 40 cases of non neoplastic intestinal polyps as control group, Preoperative anorectal dynamics index (anal resting pressure(ARP), rectal resting pressure(RRP)and anal maximal contraction pressure(MSP), rectal maximum tolerated volume(MTV) of two groups were compared, Preoperative and 3 d, 1, 2 weeks after operation of serum CEA and CA724 levels were detected in the research group and the clinical curative effect was observed. Results: There was no significant difference of ARP, RRP, MSP, MTV before operation in research group compared with the control group(P>0.05), and was significantly reduced 2, 4 weeks after operation(P<0.05), then gradually restored, and basically recovered to the preoperative level 12 weeks after operation. There was no significant difference of serum CEA and CA724 levels 3 d after operation compared with preoperative in research group(P>0.05), and were significantly lower 1, 2 weeks after operation compared with preoperative(P<0.05). The clinical effective rate was 65.8%. Conclusion: Efficacy of laparoscopic minimally invasive in treatment of rectal cancer is effective, can effectively reduce the levels of tumor markers, although there are some influence on anorectal dynamics, but it can be returned to normal in the short term.