摘要
目的探讨腹腔镜手术对结肠癌患者免疫功能和应激反应影响。方法将86例接受手术治疗的结肠癌患者随机分为腹腔镜组和开放组,每组43例。比较两组患者围手术期资料:术前1 d和术后7 d的CD3^+、CD4^+、CD8^+和CD4^+/CD8^+细胞数目和比值。C反应蛋白(CRP)、空腹血糖(BG)、白细胞介素(IL-6)和WBC水平。应用SPSS 20.0软件包进行数据处理,计量资料以(x珋±s)表示,采用t检验;计数资料采用χ~2检验或者Fisher检验;等级资料采用秩和检验。P<0.05为差异具有统计学意义。结果两组患者手术时间、淋巴结清扫个数和并发症发生率差异无统计学意义(P>0.05);腹腔镜组术中流血量、排气时间及住院时间分别为(254.6±87.5)ml、(22.9±2.2)h、(11.1±3.2)d显著低于开放组(478.5±96.3)ml、(37.1±3.4)h、(18.4±5.5)d(t=11.284,t=22.993,t=7.523,P<0.01);术前两组患者免疫指标和应激指标均无统计学差异(P>0.05),术后7 d时腹腔镜组患者CD3^+、CD4^+、CD4^+/CD8^+分别为(71.4±6.5)、(47.4±6.2)、(2.58±1.18),开放组组患者分别为(63.4±7.1)、(37.5±5.8)、(2.04±0.93),腹腔镜组均显著高于开放组(t=5.450,t=7.646,t=2.357,P<0.01);术后7 d时腹腔镜组CRP、BG、IL-6和WBC水平分别为(3.92±1.21)mg/L、(5.97±0.78)mmol/L、(1.05±0.11)10ng/L、(6.57±0.88)×10~9/L,开腹组分别为(5.31±1.58)mg/L、(7.34±1.12)mmol/L、(1.31±0.22)10ng/L、(7.64±1.79)×10~9/L,腹腔镜组显著低于开腹组(t=4.580,t=6.582,t=6.932,t=3.485,P<0.01);上述差异均有统计学意义。结论腹腔镜手术对结肠癌患者的应激反应较轻且免疫功能影响较小,具有临床应用价值。
Objective To investigate the effect of laparoscopic surgery on the immune system and stress response in patients with colon cancer. Methods Eighty-six patients with colon cancer undergoing laparoscopic surgery were randomly divided into a laparoscopic group and an open group（ 43 patients in each group）.Preoperative and postoperative pathological data,CD3＋,CD4＋,CD8＋and CD4＋/ CD8＋cells and ratios were collected. C-reactive protein（ CRP）,fasting blood glucose（ BG）,interleukin（ IL-6） and white blood cell count（ WBC） were compared between two group at one day before operation and 7 days after surgery. SPSS 20 software package was used for data analysis. The measurement data were represented as mean ± SD and examined by Student＇s t test. The count data were examined by the Chi-square test or Fisher＇s exact test. P 〈 0. 05 was considered statistically significant. Results There was no significant difference in operative time,lymph node dissection,and complications rate between thetwo groups（ P〉 0. 05）. The volume of blood loss,initial exhaust time,and discharge time in the laparoscopic group were（254.6±87.5） ml,（22.9±2.2） h,and（11.1±3.2）d,respectively,which were significantly lower than those（478.5±96.3） ml,（37.1±3.4） h,（18.4±5.5） d in the open group（t=11.284,t=22.993,t=7.523,P〈0.01）. There was no significant difference inimmune response and stress indicators between the two groups（P〉0.05）. At 7 days after surgery,CD3＋,CD4＋,and CD4＋/ CD8＋in the laparoscopic group were（71.4±6.5）,（47.4±6.2）,and（2.58±1.18） respectively,which were significantly higher than those（63.4±7.1）,（37.5±5.8）,and（2.04±0.93） in the open group（t=5.450,t=7.646,t=2.357,P〈0.01）. CRP,BG,IL-6,and WBC in the laparoscopic group were（3.92±1.21） mg/L,（5.97±0.78） mmol/L,（1.05±0.11）10 ng/L,and（6.57±0.88） × 109/ L respectively,which were also significantly lower than those（5.31±1.58） mg / L,（7. 34±1. 12） m
出处
《中华普外科手术学杂志（电子版）》
2016年第2期123-126,共4页
Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)
基金
2011年深圳市南山区科技计划区属事业单位研发项目(2011009)~~
关键词
结肠肿瘤
腹腔镜检查
免疫
应激
Colonic neoplasms
Laparoscopy
Immunity
Stress
