摘要
目的:探讨胃癌合并肝硬化患者行腹腔镜胃癌根治术对患者免疫功能的影响。方法:选择胃癌合并肝硬化患者72例,根据随机信封抽签原则分为腹腔镜组与对照组各36例。对照组采用传统开腹胃癌根治术治疗,腹腔镜组采用腹腔镜胃癌根治术治疗,检测两组患者免疫功能的变化情况,观察与随访患者的预后。结果:两组手术时间、淋巴结清扫数目对比差异均无统计学意义(均P>0.05),腹腔镜组的术中出血量、术后胃肠道恢复时间、术后拔除胃管时间、术后住院时间均少于对照组(均P<0.05)。腹腔镜组术后7 d的发热、出血、吻合口漏、肠梗阻、胃瘫等并发症发生率为8.3%,低于对照组的33.3%(P<0.05)。腹腔镜组与对照组术后7 d的血清高尔基体跨膜糖蛋白73(GP73)、甲胎蛋白L3(AFP-L3)均低于术前1 d(均P<0.05),腹腔镜组均低于对照组(均P<0.05)。两组术后7 d的CD_(4)^(+)T细胞比例高于术前1 d(P<0.05),腹腔镜组高于对照组(P<0.05),两组手术前后CD_(3)^(+)T细胞比例对比差异无统计学意义(P>0.05)。随访到2021年1月,腹腔镜组复发率为5.6%,低于对照组的22.2%(P<0.05)。结论:胃癌合并肝硬化患者行腹腔镜胃癌根治术能促进机体免疫功能的恢复,抑制肝功能标志物的表达,减少对患者的创伤与并发症的发生,从而促进患者康复,降低复发率。
Objective:To investigate the influence of laparoscopic radical gastric cancer resection on immune function in patients with gastric cancer and liver cirrhosis.Methods:72 cases of patients with gastric cancer and liver cirrhosis were selected and divided into laparoscopic group and control group with 36 cases in each groups.The control group was treated with traditional laparotomy radical gastric cancer,and the laparoscopic group was treated with laparoscopic radical gastric cancer.The changes in the immune function of the patients were measured.Results:There were no significant differences in the operation time and the number of lymph node dissection between the two groups(all P>0.05).The intraoperative blood loss,postoperative gastrointestinal recovery time,postoperative gastric tube removal time,postoperative hospital stay in the laparoscopic group were less than those in the control group(all P<0.05).The incidence of complications such as fever,bleeding,anastomotic leakage,intestinal obstruction,and gastroparesis in the laparoscopic group at 7 days after operation were 8.3%,which were lower than 33.3%in the control group(P<0.05).The serum Golgi transmembrane glycoprotein 73(GP73)and alpha-fetal protein L3(AFP-L3)in the laparoscopic group and the control group at 7 days after operation were lower than that of the preoperative 1 day,and the laparoscopic group were lower than the control group(all P<0.05).The ratio of CD 4^(+)T cells in the two groups at 7 days after operation were higher than that in the 1 day before operation,and the laparoscopic group were higher than that in the control group(all P<0.05).There were no significant differences in the ratio of CD 3^(+)T cells before and after operation between the two groups(all P>0.05).Followed-up until January 2021,the recurrence rate in the laparoscopic group was 5.6%,which was lower than 22.2%in the control group(P<0.05).Conclusion:Laparoscopic laparoscopic radical gastric cancer resection for patients with gastric cancer and liver cirrhosis can promote the
作者
申辽辽
高艳菊
SHEN Liaoliao;GAO Yanju(Department of Laboratory Medicine,Yulin No.2 Hospital,Yulin 719000,China)
出处
《陕西医学杂志》
CAS
2021年第5期590-593,共4页
Shaanxi Medical Journal
基金
陕西省科技厅科技攻关项目(2018KS-14-03)。
关键词
胃癌
肝硬化
腹腔镜胃癌根治术
免疫功能
肿瘤标志物
并发症
Gastric cancer
Liver cirrhosis
Laparoscopic radical gastric cancer resection
Immune function
Tumor marker
Complication
