腹腔镜直肠癌根治术对机体的炎性反应及免疫功能的影响  

Effect of laparoscopic radical operation on inflammatory response and systemic immunity in patients with colorectal cancer

作　　者：王贵和[1] 赵铁军[1] 束宽山[1] 孙学工[1] 

机构地区：[1]安徽省铜陵市人民医院普外二科,244000

出　　处：《腹部外科》2007年第6期354-355,共2页Journal of Abdominal Surgery

摘　　要：目的探讨腹腔镜手术治疗直肠癌对机体全身炎性反应和免疫机能的影响。方法将我院2004年11月～2006年11月收治的直肠癌39例随机分为腹腔镜手术组(19例)和开腹手术组(20例),分别在术前1d和术后1d及5d取外周血,测定白介素(IL)-6、肿瘤坏死因子(TNF)、C反应蛋白(CRP)及CD3+、CD4+、CD8+等各项指标并进行比较。结果开腹组术后第1d,IL-6、TNF及CRP明显高于腹腔镜组(P<0.01);术后第5d,IL-6、TNF两组间差异无统计学意义(P>0.05),但CRP下降缓慢,两组仍有差异(P<0.01)。开腹组术后第1d、5d,CD4+、CD8+细胞均明显低于术前(P<0.01)。而腹腔镜组术后第1d,CD4+、CD8+细胞下降低于开腹组(P<0.01);术后第5d,与术前相比无统计学差异(P>0.05)。结论腹腔镜手术治疗直肠癌的全身炎性反应较开腹手术者轻,且具有保护机体的免疫功能之优势。Objective To investigate the effects of laparoscopic radical operation on inflammatory response and systemic immunity in patients with colorectal cancer. Methods Thirty-nine patients with colorectal cancer were randomly divided into laparoscopic（ 19 cases）and open operation groups（20 cases）from Nov. 2004 to Nov. 2006. IL-6,TNF and CRP were determined and CD3^＋ cells,CD4^＋ cells and CD8^＋ cells in peripheral blood were counted and compared on the 1 st day before operation, and the 1st day and 5th day after operation. Results Levels of IL-6,TNF and CRP on the 1st day after operation in open surgery groupwere significantly higher than those in laproscopic group（P〈0. 01 ）, but there were no differences on the 5th day after operation between the two groups in IL-6 and TNF（P〉 0. 05）. In open operation group,the number of CD4^＋ cells and CD8^＋ cells was all significantly less on the 1 st and 5th day after operation than that on the 1 st day before operation（P〈0. 01 ）, and that number of CD4^＋ cells and CD8^＋ cells on the 1 st day after operation in laparoscopic group was significantly more than that in open operation group（P〈0. 01 ）. Conclusion Compared with open radical operation, laparoscopic radical operation is slighter in systemic inflammatory response and has predominance in protecting systemic immunity to treat colorectal cancer.

关 键 词：外科学 腹腔镜 直肠肿瘤 免疫系统 炎症 

分 类 号：R735.37[医药卫生—肿瘤]