腹腔镜微创手术与传统开腹手术对结直肠癌患者免疫和生理功能影响的临床观察  

Effect of Laparoscopicand Open Operations on the Immune and Physiological Responses in Patients with Colorectal Cancer

作　　者：汤雪峰[1] 李财宝[1] 刘岗[1] 张浩[1] 张熹玮[1] 黄建平[1] 

机构地区：[1]上海中医药大学附属曙光医院普外科,上海200021

出　　处：《标记免疫分析与临床》2015年第4期278-281,共4页Labeled Immunoassays and Clinical Medicine

基　　金：上海中医药大学附属曙光医院第二批临床重点专科专病建设项目(项目编号730)

摘　　要：目的探讨对于临床确诊为结直肠癌患者采用腹腔镜手术较传统开放手术的免疫和生理反应方面的影响。方法选取2013年6月至2014年6月经临床确诊为结直肠癌并于我院消化外科采用腹腔镜手术治疗的50例患者为观察组,同期采用传统开腹手术进行治疗的50例患者为对照组,比较分析两组患者的免疫和生理反应的变化。结果与对照组比较,术后7天CD4/CD3、术后3天Ig M在观察组中升高、术后3天IL-6和CPR在观察组中降低,差异具有统计学意义(P<0.01);与对照组比较,术后7天TNF-α在观察组中降低,差异具有统计学意义(P<0.05)。在生理功能的比较中,观察组患者在胃动素和胃泌素的分泌方面优于对照组,差异具有统计学意义(P<0.05)。结论因腹腔镜手术对患者的免疫和生理功能的损伤小,更有利于健康的恢复,值得在临床上推广使用。Objective To investigate the effect of laparoscopic and traditional open operation on immune and physiological responses of patients with colorectal cancer. Methods 50 patients clinically diagnosed for colorectal cancer and digestive surgery by laparoscopic operation and 50 cases of colorectal cancer patients with traditional open operation were chosen as the observation group and control group. The changes of comparative analysis of immune and physiological responses of two groups of patients were carried out. Results Compared with control group, the content of CD4/CD3 in observation group at 7 days after operation and IgM levels after 3 days were increase and the serum levels of IL-6 and CPR were decreased （ P 〈 0. 01 ）. The TNF-alpha levels in observation group at 7 days after operation were decreased （ P 〈 0.05 ）. The motilin and gastrin secretion in observation group were better than that of in the control group （ P 〈 0.05 ）. Conclusion The laparoscopic surgery with less damage on immune and physiological function of patients with colorectal cancer is much more conducive to the recovery of health and it is worth for widely clinical application.

关 键 词：腹腔镜手术 开腹手术 结直肠癌 免疫功能 生理反应 

分 类 号：R735.34[医药卫生—肿瘤]