腹腔镜直肠癌根治术治疗直肠癌的效果及对血清疼痛因子、miR-103、miR-21与肛肠动力学指标的影响

Effect of laparoscopic radical resection of rectal cancer in treatment of rectal cancer and its impact on serum pain factors, miR-103, miR-21 and anorectal dynamics indexes

摘要:

目的 探讨腹腔镜直肠癌根治术治疗直肠癌的效果及对血清疼痛因子、miR-103、miR-21和肛肠动力学指标的影响。方法 选取2017年9月－2019年12月该院直肠癌患者93例进行前瞻性随机对照研究，简单随机化法分为观察组（n = 46）和对照组（n = 47）。观察组采取腹腔镜直肠癌根治术，对照组行传统开腹手术。比较两组手术情况、并发症发生率、术前、术后1 d、术后3 d血清疼痛因子［神经肽Y（NPY）、前列腺素E₂（PGE₂）、神经生长因子（NGF）］、术前、术后1周、术后2周miR-103、miR-21水平和术前、术后4周、术后8周肛肠动力学指标［肛管最长收缩时间（ALCT）、肛管最大收缩压（AMCP）、直肠静息压（RRP）］水平。结果 两组患者手术时间和淋巴结清扫数目比较，差异均无统计学意义（P > 0.05）；观察组术中出血量少于对照组，肛门排气时间、进食时间和住院时间均较对照组短（P < 0.05）；两组患者术后1和3 d血清NPY、PGE₂和NGF水平均较术前提高，但观察组低于对照组（P < 0.05）；两组患者术后1和2周血清miR-103和miR-21较术前降低，且观察组低于对照组（P < 0.05）；两组患者术后4和8周ALCT、AMCP和RRP水平较术前降低，但观察组高于对照组（P < 0.05）。结论 腹腔镜直肠癌根治术应用于直肠癌患者，能有效减少术中出血量，缩短患者术后恢复时间，且抑制疼痛因子表达，调节血清miR-103和miR-21水平，促进患者肛肠动力学恢复。

Abstract:

Objective To investigate the effect of laparoscopic radical resection of rectal cancer in treatment of rectal cancer and its impact on serum pain factors, miR-103, miR-21 and anorectal dynamics.Methods A prospective randomized controlled study of 93 patients with rectal cancer from September 2017 to December 2019 was performed. They were divided into observation group (n = 46) and control group (n = 47) by simple randomization method. The observation group received laparoscopic radical resection of rectal cancer, and the control group underwent traditional open surgery. The surgical conditions and the incidence rate of complications, serum pain factors [neuropeptide Y (NPY), prostaglandin E₂ (PGE₂), nerve growth factor (NGF)] before operation, 1 d, and 3 d after operation, miR-103 and miR-21 before operation, 1 week after operation and 2 weeks after operation, anorectal dynamics indexes [anal longest contraction time (ALCT), anal maximum contraction pressure (AMCP), and resting rectal pressure (RRP)] levels before operation, 4 weeks after operation, and 8 weeks after operation were compared between the two groups.Results There was no significant difference in the operation time and the number of lymph node dissection between the two groups (P > 0.05); The intraoperative blood loss in the observation group was lower than that in the control group, and the anal exhaust time, eating time, and hospitalization time were shorter than those in the control group (P < 0.05); The serum NPY, PGE₂ and NGF levels of the two groups at 1 and 3 days after operation were higher than those before the operation, but the observation group was lower than that in control group (P < 0.05). The levels of serum miR-103 and miR-21 in the two groups at 1 week and 2 weeks after the operation were lower than those before the operation, and the observation group was lower than that in control group (P < 0.05). The levels of ALCT, AMCP and RRP in the two groups were lower than those before the operation at 4 weeks and 8 weeks after the operation, but the observation group was higher than that in control group (P < 0.05).Conclusion Application of laparoscopic radical resection of rectal cancer in patients with rectal cancer can effectively reduce intraoperative blood loss, shorten postoperative recovery time, inhibit expression of pain factors, regulate serum miR-103 and miR-21 levels, and promote the recovery of anorectal dynamics in patients.