胸腔镜下与开胸肺叶切除术对非小细胞肺癌患者炎症因子及免疫功能的影响  

Effect of video-assisted thoracoscopic surgery and traditional open surgery on the inflammatory cytokine and immune function in patients with non-small cell lung carcinoma

作　　者：吕兵[1] 陶永忠[1] 吴旌[1] 钟斌[1] 罗富超 刘洋[1] 张泽学[1] 

机构地区：[1]重庆市涪陵中心医院胸心外科,重庆408000

出　　处：《海南医学院学报》2016年第16期1816-1818,共3页Journal of Hainan Medical University

基　　金：重庆涪陵科研课题计划(FLXJ 2012ABB1113)~~

摘　　要：目的:探讨全胸腔镜下肺叶切除术(VATS)与开胸肺叶切除术(TOS)对非小细胞肺癌患者炎症因子及免疫功能的影响。方法:选取68例非小细胞肺癌患者,依据手术方式分为TOS组与VATS组,各34例,术后比较两组手术时间、术中出血量、切口长度及淋巴结清扫数目等临床相关指标,检测并比较术后两组血清白介素-6(IL-6)及C-反应蛋白(CRP)等炎症因子水平的变化,并分析两组手术前后的免疫功能状态。结果:与TOS组比较,VATS组手术时间及术中出血量明显减少,切口长度明显缩短(P<0.01);与术前比较,术后两组Ig G水平,CD4^+、CD8^+T淋巴细胞水平及CD4^+/CD8^+均有明显下降,且TOS组低于VAST组(P<0.05或P<0.01);术后1 d,两组IL-6、CRP水平明显升高,且TOS组高于VAST组(P<0.01);术后5 d,VATS组IL-6、CRP水平与术前无差异(P>0.05),而TOS组仍显著高于术前(P<0.01)。结论:VATS治疗非小细胞肺癌疗效显著,可明显减轻机体炎症反应,并有利于保护机体免疫功能。Objective： To explore the effect of video-assisted thoracoscopic surgery（ VATS） and traditional open surgery（ TOS） on the inflammatory cytokine and immune function in patients with non-small cell lung carcinoma. Methods： A total of 68 patients with non-small cell lung carcinoma were included in the study and divided into VATS group and TOS group according to different surgical methods with 34 cases in each group. The operation time,intraoperative amount of bleeding,incision length,and lymph node dissection number after operation in the two groups were compared. The levels of serum IL-6 and CRP after operation in the two groups were detected and compared. The immunological function status before and after operation in the two groups was analyzed. Results：The operation time and intraoperative amount of bleeding in VATS group were significantly reduced,and the incision length was significantly shortened when compared with TOS group（ P〈0. 05）. Ig G,CD4~＋,and CD8~＋levels,and CD4~＋/ CD8~＋after operation in the two groups were significantly reduced when compared with before treatment,and those in TOS group were significantly lower than those in VATS group（ P〈0. 05 or P〈0. 01）. IL-6 and CRP levels 1d after operation in the two groups were significantly elevated when compared with before operation,and those in TOS group were significantly higher than those in VATS group（ P〈0. 05）. IL-6 and CRP levels 5d after operation in VATS group were not significantly different from those before operation（ P〈0. 05）,while those in TOS group were significantly elevated when compared with before operation（ P〈0. 01）. Conclusions： VATS in the treatment of nonsmall cell lung carcinoma has a significant efficacy,can significantly alleviate the inflammatory reaction,and is beneficial to protect the immunological function.

关 键 词：非小细胞肺癌 全胸腔镜下肺叶切除术(VATS) 开胸肺叶切除术(TOS) 炎症因子 免疫球蛋白 淋巴细胞 

分 类 号：R734.2[医药卫生—肿瘤]