摘要
目的探讨电视胸腔镜与开胸肺叶切除术在早期非小细胞肺癌治疗中的临床疗效,及其对患者炎症因子与免疫功能的影响。方法将96例早期非小细胞肺癌(NSCLC)患者随机分成对照组与观察组,每组各48例,其中对照组行传统开胸肺叶切除术,观察组行电视胸腔镜肺叶切除术。对比两组患者的淋巴结清除数、手术时间、术中出血量、术后置管引流时间及住院时间,此外并对比两组患者术前与术后3天C反应蛋白(CRP)、白细胞介素6(IL-6)、淀粉样蛋白A(SAA)、肿瘤坏死因子α(TNF-α)等炎症因子及CD4^+T细胞、CD8^+T细胞、CD4^+T/CD8^+T、自然杀伤细胞(NK)等免疫细胞所占比例。结果两组患者的淋巴结清除数组间比较差异无统计学意义(P>0.05);观察组患者的手术时间、术中出血量、术后置管引流时间及住院时间均显著低于对照组,差异有统计学意义(P<0.05);术后3天两组患者的CRP、IL-6、SAA及TNF-α水平均显著升高,而CD4^+T、CD8^+T及NK细胞水平均显著降低,且观察组炎症因子各指标的上升程度及免疫细胞水平的下降程度均显著低于对照组,差异有统计学意义(P<0.05)。结论电视胸腔镜肺叶切除术的效果显著,且能够降低术后的急性期炎症反应,弱化对患者免疫功能的抑制程度,值得在临床上推广。
Objective To compare the effect of video assisted thoracic surgery with conventional thoracotomy on inflammatory factors and immune function in patients with early stage non-small cell lung cancer. Methods A total of 96 cases of early non-small cell lung cancer（ NSCLC） were divided into two groups,The control group had 48 cases with conventional thoracotomy and the observed group had 48 cases with video-assisted thoracoscopic lobectomy（ VATS）. Numbers of removed lymph nodes,operation duration,volumes of intraoperative bleeding,duration of postoperative catheter drainages,and length of postoperative hospital stay of two groups were compared. C reactive protein（ CRP）,IL 6（ IL-6）,amyloid A（ SAA）,tumor necrosis factor alpha（ TNF alpha） of preoperative and third postoperative day were measured, as well as inflammatory cytokines,CD4＋T cells,CD8＋T cells,CD4＋/ CD8＋T cells and natural killer（ NK） cells in immune cell proportion. Results No statistical significance was found in numbers of lymph nodes removal between two groups（ P 〉 0. 05）. The operation duration,volumes of intraoperative bleeding,duration of postoperative catheter drainages,and length of postoperative hospital stay in observation group were significantly shorter than that of control group（ P〉 0. 05）. CRP,IL-6 and serum amyloid A（ SAA） andTNF-α level on the 3rd day postoperative were significantly increased in two group,CD4＋,CD8＋T lymphocytes and NK cell levels were significantly decreased when compared with the preoperative levels. The inflammatory cytokines in each index were significantly increased and the levels of immune cells were significantly lower in observed group than those in the control group（ P 〈 0. 05）. Conclusion VATS lobectomy shows advantages in many aspects. Itreducesacute inflammationpostopertively, weakens the inhibitory immune function. It is worth of recommendation for more clinical use.
出处
《标记免疫分析与临床》
CAS
2016年第11期1330-1333,共4页
Labeled Immunoassays and Clinical Medicine
