| 金艳婷,郭智琴,王珍.腹腔镜根治性切除术治疗膀胱癌及对血清胰岛素样生长因子及其结合蛋白 -3的影响[J].安徽医药,2022,26(11):2261-2265. |
| 腹腔镜根治性切除术治疗膀胱癌及对血清胰岛素样生长因子及其结合蛋白 -3的影响 |
| Laparoscopic radical resection for bladder cancer and its effect on serum insulin-like growth factor and its binding protein-3 |
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| DOI：10.3969/j.issn.1009-6469.2022.11.032 |
| 中文关键词: 膀胱肿瘤 膀胱切除术 腹腔镜根治性切除术 胰岛素样生长因子结合蛋白 -3 胰岛素样生长因子 -1 凝血功能 炎性反应 |
| 英文关键词: Urinary bladder neoplasms Cystectomy Laparoscopic radical resection IGFBP-3 IGF-1 Coagulation In. flammatory reaction |
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| 中文摘要: |
| 目的研究腹腔镜根治性切除术(LRC)治疗膀胱癌(BC)及对血清胰岛素样生长因子 -1(IGF-Ⅰ)及其结合蛋白 -3(IGFBP-3)的影响。方法纳入 2014年 1月至 2018年 12月于武汉市汉口医院接受治疗的 BC病人 116例，依据随机数字表法分为 LRC组(n=58)与开放根治性切除术(ORC)组(n=58)。ORC组行 ORC，LRC组行 LRC。观察两组术中出血量、手术时间、术后疼痛评分、肛门排气时间、住院时间等围术期指标，术前及术后 3d血清 γ-干扰素、白细胞介素 -6等炎性因子，血清 IGFBP-3、IGF-Ⅰ等肿瘤因子。术后并发症等。结果 LRC组术中出血量、术后疼痛评分、肛门排气时间、住院时间等指标均小于 ORC组［(448.97±46.65) mL比(747.68±77.39)mL、(5.15±0.54)分比(7.46±0.76)分、(3.68±0.38)d比(4.48±0.47)d、(17.67±1.92)d比( 21.86±2.22)d］手术时间大于 ORC组［(318.96±33.44)min比(276.84±29.85)min］(P<0.05)。术后 3d，LRC组 IL-6水平均低于 ORC组［(123.86±1379) ng/L比( 130.86±14.93)ng/L］，IFN-γ水平高于 ORC组［(15.84±1.75)ng/L比( 14.96±1.52)ng/L］(P<0.05)。术后 3d，两组 IGFBP-3、IGF-Ⅰ水平均差异无统计学意义［(179.75±19.57)mg/L比(182.61±19.62)mg/L、(2.74±0.29)μg/L比(2.70±0.28)μg/L］(P>0.05)。 LRC组术后并发症发生率(3.45%)低于 ORC组(13.79%)(P>0.05)。结论 LRC可有效切除 BC病灶，改善 IGFBP-3、IGF-Ⅰ水平，对机体凝血功能影响小，术后炎症反应轻，疗效与 ORC一致，且创伤小，术后并发症发生率低，术后恢复快。 |
| 英文摘要: |
| Objective To study the effects of laparoscopic radical resection (LRC) on bladder cancer (BC) and serum insulin-like growth factor (IGF-Ⅰ) and its binding protein-3 (IGFBP-3).Methods A total of 116 BC patients who were treated in Hankou Hospitalof Wuhan from January 2014 to December 2018 were included and divided into the LRC group (n=58) and open radical resection (ORC) group (n=58) according to the random number table method. Patients in the ORC group underwent ORC, and patients in theLRC group underwent LRC. The intraoperative blood loss, operative time, postoperative pain score, anal exhaust time, hospitalizationtime and other perioperative indicators were observed in the two groups. Serum inflammatory factors, such as interferon-γ (IFN-γ), inter. leukin 6 (IL-6), serum IGFBP-3, IGF-1 and other tumor factors, and postoperative complications before surgery and 3 days after surgery were also observed.Results The intraoperative blood loss, postoperative pain score, anal exhaust time, hospital stay and other indica.tors in the LRC group were smaller than those in the ORC group [(448.97±46.65) mL vs. (747.68±77.39) mL, (5.15±0.54) vs. (7.46± 0.76), (3.68±0.38) d vs. (4.48±0.47) d, (17.67±1.92) d vs. (21.86±2.22) d], and the operation time was longer than that in the ORC group [(318.96±33.44) min vs. (276.84±29.85) min] (P<0.05). On the 3rd day after the operation, the level of IL-6 in the LRC group was lower than that in the ORC group [(123.86±13.79) ng/L vs (130.86±14.93) ng/L], and the level of IFN-γ was higher than that in the ORC group [(15.84±1.75) ng/L vs (14.96±1.52) ng/L] (P<0.05). On the 3rd day after the operation, there was no significant difference in the levels of IGFBP-3 and IGF-1 between the two groups [(179.75±19.57) mg/L vs. (182.61±19.62) mg/L, (2.74±0.29) μg/L vs. (2.70±0.28) μg/L] (P>0.05). The incidence of postoperative complications in the LRC group (3.45%) was lower than that in the ORC group(13.79%) (P<0.05).Conclusions LRC can effectively remove BC lesions, improve the levels of IGFBP-3 and IGF-1, and have little ef.fect on the body's coagulation function. In addition, the postoperative inflammatory reaction of LRC is mild, the curative effect is consis.tent with ORC, the trauma is small, the incidence of postoperative complications is low, and the recovery is fast. |
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