摘要
目的比较腹腔镜与开腹2种不同的手术方式对于行右半结肠癌根治术患者的免疫功能的影响。方法采取回顾性研究方法,将2012年1月到2014年10月的100名符合入组要求的患者根据手术方法的不同分为腹腔镜组50例,开腹组50例,比较2组患者的手术前后C反应蛋白(CRP)、白细胞(WBC)、白细胞介素(IL)-6、CD4+、CD8+、CD4+/CD8+、NK细胞、淋巴细胞数(Lymph)的变化。结果与手术前比较,腹腔镜组WBC、CRP、IL-6升高,差异有统计学意义(P<0.05),开腹组WBC、Lymph、CRP、IL-6升高差异有统计学意义(P<0.05)。手术后腹腔镜组与开腹组比较CRP、IL-6、CD4+、CD8+差异有统计学意义(P<0.05)。腹腔镜组与开腹组腹腔引流液WBC、IL-6比较差异有统计学意义(P<0.05)。结论只要严格掌握手术适应征,腹腔镜右半结肠根治术可以达到同常规开腹手术相同的根治效果,且对机体免疫功能影响较小,可以在临床推广。
Objective To compare the effects of right colon cancer radical operation by laparoscopy and laparotomy on the immune system of the patients. Methods A retrospective study was made on the 100 patients admitted into the hospital from January,2012 to October,2014. According to different surgical methods,the patients were divided into the laparoscopic group and the laparotomy group,each consisting of 50 patients. Levels of C reactive protein（ CRP）,white blood cell（ WBC）,interleukin（ IL-6）,CD4＋/CD8＋,NK,and lymphocyte were compared between the patients of the 2 groups after surgery. Results As compared with those before surgery,the levels of WBC,CRP and IL-6 of the laparoscopic group were increased,with statistical significance（ P〈0. 05）. As compared with those before surgery,the levels of WBC,Lymph,CRP and IL-6 of the laparotomy group were elevated,also with statistical significance（ P〈0. 05）. There was statistical significance in the levels of CRP,IL-6,CD4＋,CD8＋,when comparisons were made between the 2 groups（ P〈0. 05）. There was also statistical significance in the levels of WBC and IL-6 in peritoneal fluid,when comparisons were made between the 2 groups（ P〈0. 05）. Conclusion So far as surgical indications were strictly taken into consideration,right colon cancer radical operation by laparoscopy could achieve identical treatment results as conventional laparotomy. Furthermore,it seemed to have less effect on the immune system,for this reason,it was worth further clinical application.
出处
《海军医学杂志》
2015年第5期419-420,469,共3页
Journal of Navy Medicine
基金
临沂市科技发展计划基金项目(201413038)
关键词
细胞免疫功能
腹腔镜
结肠肿瘤
全肠系膜切除
Cell immune function
Laparoscopy
Colorectal neoplasm
Full mesenterectomy
