腹腔镜根治术治疗胃癌的效果观察及其免疫功能和应激炎性因子的变化情况分析  

Changes of immune function and inflammatory factors of patients with gastric cancer treated by laparoscopic radical resection

作　　者：张治国[1] 薛慧婧[1] 宋仕茂[1] 骆志国[1] 

机构地区：[1]湖北医药学院附属十堰市太和医院肿瘤科,湖北十堰442000

出　　处：《胃肠病学和肝病学杂志》2015年第6期724-727,共4页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的观察腹腔镜根治术治疗胃癌的效果,并探讨胃癌患者的免疫功能及应激炎性因子的变化情况。方法选择2013年4月-2014年6月十堰市太和医院肿瘤科收治择期行根治性切除术胃癌患者86例,分为腹腔镜组和开腹组。腹腔镜组患者应用腹腔镜胃癌根治术予以治疗,开腹组患者应用开腹胃癌根治术予以治疗。比较两组患者的治疗效果、免疫功能和应激炎性因子的变化情况。结果腹腔镜组手术时间显著高于开腹组,腹腔镜组术中出血量、切口长度、肛门排气时间明显小于开腹组,差异有统计学意义(P<0.05);腹腔镜组与开腹组CD3、CD4+、CD8+、CD19、NK细胞比例较术前均显著降低(P<0.05),并且腹腔镜组较开腹组NK细胞比例降低,差异有统计学意义(P﹤0.05);腹腔镜组ET、CRP、IL-6水平较术前明显下降(P﹤0.05),NO无明显变化;开腹组CRP、IL-6较术前明显下降(P﹤0.05),而ET、NO显著提高(P﹤0.05);腹腔镜组ET、CRP、NO、IL-6水平较开腹组显著降低,差异有统计学意义(P﹤0.05)。结论腹腔镜胃癌根治术,能够获得较开腹胃癌根治术更好的临床效果,具有创口小、术中出血少及术后恢复快等特点,值得临床推广。Objective To observe the effect of laparoscopic radical resection for patients with gastric cancer, and in- vestigate the changes of immune function and inflammatory factors of patients with gastric cancer. Methods Eighty-six patients with gastric cancer from Apr. 2013 to Jun. 2014 in Taihe Hospital of Shiyan City were selected, who received radical resection, and divided into laparoscopic group and open group. The patients of laparoscopic group were treated with laparoscopic gastrectomy, and the patients of open group were treated with open gastrectomy. Changes of immune function and inflammatory stress factors were compared between the two groups. Results After appropriate surgery, lap- aroscopic operative time of laparoscopic group were significantly higher than that of open group, and the blood loss, inci- sion length and flatus time of the laparoscopic group were significantly less than those of open group （ P 〈 0.05 ） ; The CD3, CD4＋ , CD8＋ , CO19, NK cells of two groups were significantly lower postoperative than preoper（P 〈 0.05） , the NK cells of laparoscopic group were lower than that of the those open group（P 〈 0.05）. The ET, CRP, IL-6 levels of laparoscopic group were decreased significantly postoperative compared with preoperative （P 〈 0.05 ） , while the level of NO had no significant changes ; The levels of CRP, IL-6 of laparotomy group were decreased significantly compared with preoperative （P 〈 0.05） , and the levels of ET, NO were increased significantly compared with preoperative （P 〈 0.05） , The levels of ET, CRP, NO, IL-6 of laparoscopic group were significantly lower than those of open group（P 〈 0.05）. Conclusion The patients with gastric cancer, who were treated with laparoscopic gastrectomy, can obtain better clinical results than open gastrectomy, and it also has some characteristics, like a small wound, less blood loss and fas- ter recovery.

关 键 词：胃癌 腹腔镜 开腹 免疫功能 应激炎性因子 

分 类 号：R735.2[医药卫生—肿瘤]