腹腔镜直肠癌根治术对患者免疫功能影响的研究  

Effect of Laparoscopic Radical Operation on Immune Function in Patients with Colorectal Cancer

作　　者：周志涛[1] 李俊[1] 毛常青 吕培标 伍联华 钟国英[1] 王存川[2] 

机构地区：[1]广东省梅县人民医院普外科,广东梅县514011 [2]暨南大学第一附属医院微创外科中心

出　　处：《实用预防医学》2011年第5期895-897,共3页Practical Preventive Medicine

摘　　要：目的探讨腹腔镜直肠癌手术对患者免疫功能的影响。方法 70例患者根据手术方式随机分为腹腔镜直肠癌根治术(腹腔镜组)和开腹直肠癌根治术(开腹组),术前1 d和术后1、3、57、d测定各免疫功能指标(CD3+、CD4+、CD8+T细胞)。观察术中出血量、淋巴结数、肠动力恢复时间及手术并发症等情况。结果腹腔镜组术中出血量、术后并发症发生率和肠道功能恢复时间均显著低于开腹组,相比较差异有统计学意义(P<0.05);两组均无阳性切缘,淋巴结清扫数比较差异无统计学意义(P>0.05);术前1 d两组CD3+、CD4+、CD8+T淋巴细胞比较差异无统计学意义(P>0.05);术后1 d两组CD3+、CD4+、CD8+T淋巴细胞较术前显著下降,术后3 d两组CD3+、CD4+、CD8+T淋巴细胞较术后1 d显著上升,术后7 d腹腔镜组CD3+、CD4+、CD8+T淋巴细胞基本达到术前水平,术后1、3、57、d腹腔镜组CD3+、CD4+、CD8+T淋巴细胞与开腹组比较差异有统计学意义(P<0.05)。结论腹腔镜直肠癌根治术可以减轻对机体细胞免疫功能的抑制作用,而且术后恢复更快,是一种安全可行的手术方式。Objective To explore the effect of laparoscopic radical operation on immune function in patients with colorectal cancer. Methods Seventy patients with colorectal cancer were divided into laparoscope group（laparoscopic radical operation） and laparotomy group（conventional open radical operation）.The immune function（CD3＋,CD4＋ and CD8＋ T cells） was detected on the 1st day before operation and 1st,3rd,4th,and 7th days after operation.Blood loss,the number of lymph nodes,gastrointestinal motility recovery time and complications were observed. Results Blood loss,postoperative complications and gastrointestinal motility recovery time in laparoscope group were significantly lower than those in laparotomy group,and the difference was statistically significant（P0.05）.There was no positive surgical margin in the two groups,and no statistically significant difference was found in the number of lymph nodes between the two groups（P0.05）.There was no statistically significant difference in CD3＋,CD4＋ and CD＋8 T cells on preoperative day 1 between the two groups（P0.05）.Compared with before the operation,the CD3＋,CD4＋ and CD8＋ T cells of the two groups decreased significantly on postoperative day 1.Compared with postoperative day 1,the CD3＋, CD4＋ and CD8＋ T cells of the two groups increased significantly on postoperative day 3.At postoperative day 7,the CD3＋,CD4＋ and CD8＋ T cells of laparoscope group basically reached the preoperative levels.There were statistically significant differences in the CD3＋,CD4＋ and CD8＋ T cells at postoperative days 1,3,5 and 7 between the two groups（P0.05）. Conclusions Laparoscopic radical operation on the body with colorectal cancer has fewer immunosuppression,and the postoperative recovery is faster.It is a safe and feasible surgical approach.

关 键 词：腹腔镜 直肠肿瘤 免疫功能 

分 类 号：R735.37[医药卫生—肿瘤]