摘要
目的探讨腹腔镜下胃癌根治术对患者术后恢复、免疫功能及应激状态的影响。方法选取2015年3月至2020年3月灵宝市第一人民医院普通外科一病区收治的75例行胃癌根治术的患者,男40例,女35例,年龄(57.13±6.32)岁,年龄范围为43~71岁,采用随机数表法将患者随机分为腹腔镜组(n=37)与开腹组(n=38)。腹腔镜组采用腹腔镜下胃癌根治术治疗,开腹组采用开腹胃癌根治术治疗,比较两组患者术后恢复情况(肛门排气时间、首次饮食时间、住院时间)、免疫功能[表面抗原分化簇4(CD4^(+))、表面抗原分化簇8(CD8^(+))、CD4^(+)/CD8^(+)]及应激状态[内皮素、白细胞介素6(IL-6)]。结果腹腔镜组术后肛门排气时间[(2.10±1.31)d]、首次饮食时间[(3.08±1.18)d]及住院时间[(9.86±2.38)d]均短于开腹组[(3.24±1.67)d、(4.12±1.35)d、(12.24±3.09)d];术后第3天,腹腔镜组CD4^(+)[(28.22±4.49)%]、CD8^(+)[(26.18±2.67)%]、CD4^(+)/CD8^(+)(1.08±0.10)均高于开腹组[(24.01±3.69)%、(24.17±2.46)%、(1.01±0.09)];术后第3天,腹腔镜组内皮素[(0.77±0.36)ng/L]、IL-6[(37.18±23.25)μg/L]均较术前[(1.35±1.10)ng/L、(58.32±20.08)μg/L]降低,开腹组内皮素[(2.25±1.88)ng/L]较术前[(1.45±1.12)ng/L]升高,IL-6[(53.16±24.37)μg/L]较术前[(63.45±20.42)μg/L]降低,且腹腔镜组内皮素、IL-6均低于开腹组,差异均有统计学意义(P<0.05)。结论胃癌患者采用腹腔镜下根治术可缩短患者术后恢复时间,改善患者免疫功能及应激状态,值得在临床上推广应用。
Objective To investigate the effect of laparoscopic radical resection of gastric cancer on the postoperative recovery,immune function and stress state of patients.Methods A total of 75 patients who underwent radical resection of gastric cancer in department of General Surgery,Lingbao First People′s Hospital from March 2015 to March 2020 were selected,including 40 males and 35 females,aged(57.13±6.32)years old,ranging from 43 to 71 years old,according to the random number table method,patients were divided into the laparoscopy group(n=37)and the open group(n=38).The laparoscopy group of patients were treated with laparoscopic radical resection of gastric cancer,and the open group of patients were treated with open radical gastric cancer.The postoperative recovery(anal exhaust time,first diet time,hospital stay),immune function[cluster of differentiation 4(CD4^(+)),cluster of differentiation 8(CD8^(+)),CD4^(+)/CD8^(+)]and stress state[endothelin(ET),interleukin-6(IL-6)]were compared between the two groups.Results The postoperative anal exhaust time[(2.10±1.31)days],first diet time[(3.08±1.18)days]and hospitalization time[(9.86±2.38)days]of the laparoscopy group were shorter than those of the open group[(3.24±1.67)days,(4.12±1.35)days,(12.24±3.09)days];on the 3rd day after operation,CD4^(+)[(28.22±4.49)%],CD8^(+)[(26.18±2.67)%],CD4^(+)/CD8^(+)(1.08±0.10)in the laparoscopy group were high than the open group[(24.01±3.69)%,(24.17±2.46)%,(1.01±0.09)];on the 3rd day after operation,the ET[(0.77±0.36)ng/L]and IL-6[(37.18±23.25)μg/L]of the laparoscopy group were reduced than those before operation[(1.35±1.10)ng/L,(58.32±20.08)μg/L],the ET level of the open group[(2.25±1.88)ng/L]was increased than that before operation[(1.45±1.12)ng/L],IL-6[(53.16±24.37)μg/L]was reduced than that before operation[(63.45±20.42)μg/L],and ET,IL-6 in the laparoscopy group were lower than those in the open group,the difference was statistically significant(P<0.05).Conclusion.Conclusion Laparoscopic radical resection o
作者
南兵
韩世权
张乔
黄彦斌
Nan Bing;Han Shiquan;Zhang Qiao;Huang Yanbin(Department of General Surgery,Lingbao First People′s Hospital,Lingbao 472500,China)
出处
《中国临床实用医学》
2021年第1期34-37,共4页
China Clinical Practical Medicine
关键词
胃癌
腹腔镜下胃癌根治术
免疫功能
应激状态
Gastric cancer
Laparoscopic radical resection of gastric cancer
Immune function
Stress state
