摘要
目的:探讨开腹与腹腔镜胃癌根治术对老年进展期胃癌患者应激反应及免疫功能的影响。方法:2015年4月至2017年6月收治的130例老年进展期胃癌患者,分为腹腔镜组与开腹组,每组65例,观察两组手术情况,并于术前1 d及术后第1天、第7天检测应激反应及免疫功能指标的变化。结果:腹腔镜组手术时间长于开腹组,术中出血量、术后肛门排气时间、住院时间均优于开腹组(P<0.05),两组术中淋巴结清扫数量差异无统计学意义(P>0.05)。两组患者术前血清IL-6、NO、CRP、CD4^+、CD8^+及CD^4+/CD^8+水平差异无统计学意义(P>0.05);与术前相比,术后第1天、第7天两组患者血清IL-6、NO及CRP水平升高(P<0.05),但腹腔镜组低于开腹组(P<0.05)。术后第1天、第7天,两组患者CD4^+、CD^8+及CD^4+/CD^8+均下降,腹腔镜组高于开腹组(P<0.05)。结论:腹腔镜胃癌根治术治疗老年进展期胃癌,可明显减轻患者机体应激反应及对免疫功能的抑制,更利于术后恢复。
Objective：To investigate the influence of laparotomy and laparoscopic radical gastrectomy on stress reaction and im- mune function in elderly patients with advanced gastric cancer, netbods：A total of 130 elderly patients with advanced gastric cancer treated from Apr. 2015 to Jun. 2017 were recruited. According to the surgical methods, all the patients were divided into laparoscopic group and laparotomy group （65 cases in each group）. The operation information of the two groups was observed, and the changes of stress reaction and immune function indexes before operation, 1 d and 7 d after operation were detected. Results ： Compared with the pa-tients in laparotomy group, the operation time of laparoscopic group was significantly prolonged, the amount of bleeding was significantly reduced, anal exhaust time and hospitalization time were significantly shorter （ P 〈 0.05 ）. There was no signific.ant difference in the number of harvested lymph nodes between the two groups （ P 〉 0.05 ） The preoperative serum levels of IL-6, NO, CRP, CD4^＋ , CD8^＋ and CD4^ ＋/CD8^＋ were not significantly different between the two groups （ P 〉 0.05 ）. The serum levels of IL-6, NO, CRP at 1 d ,7 d af ter operation were significantly higher than those before operation in the two groups, and the level of laparoscopic group was significantly lower than that of the laparotomy group （P 〈 0.05）. The level of CD4^＋ ,CD8^＋ and CD4^＋/CD8^＋ at 1 d and 7 d after operation of the two groups were significantly decreased, and the level of laparoscopic group was significantly higher than that of the laparotomy group （ P 〈 0.05 ）. Condusions：Laparoscopic radical gastrectomy for advanced gastric cancer can alleviate the stress response and the inhibition of immune function in elderly patients, which is more conducive to postoperative recovery.
作者
李作周
马水英
王花丽
LI Zuo-zhou;MA Shui-ying;WANG Hua-li(Department of General Surgery,the Staff Hospital of the Thirteenth Mining of Pingdingshan Coal Industrial Group,Pingdingshan 467000,China)
出处
《腹腔镜外科杂志》
2018年第6期426-429,共4页
Journal of Laparoscopic Surgery
关键词
胃肿瘤
胃癌根治术
腹腔镜检查
应激反应
免疫功能
Stomach neoplasms
Radical gastrectomy
Laparoscopy
Stress reaction
Immune function
