胸腔镜微创手术对早期周围型肺癌患者术后炎症反应和免疫功能的影响  

The influence of radical surgery thoracoscope on TNF alpha,IL-6,IL-10 and level of T lymphocyte subsets of patients with early peripheral lung cancer

作　　者：曾新敏[1] 王晖[1] 章志龙[1] 胡火利[1] 徐兴华[1] 陈华[1] 

机构地区：[1]南昌市第一医院,江西南昌330008

出　　处：《中国当代医药》2016年第30期65-68,共4页China Modern Medicine

摘　　要：目的观察胸腔镜早期周围型肺癌根治术对患者术后TNF—α、IL-6、IL-10等炎症因及T淋巴亚群的影响。方法将2012年8月。2015年12月于我院确诊的78例早期周围型肺癌并行手术治疗的患者纳入研究，依据手术方案分为开胸手术组40例、胸腔镜组38例．开胸手术组采用常规开胸术，胸腔镜组采用胸腔镜早期周围型肺癌根治术。观察两组TNF-α、IL-6、IL-10水平的变化情况、术后的一般情况及T淋巴亚群水平的差异。结果两组患者TNF—α、IL-6、IL-10水平均升高（P〈0．05），但组间比较胸腔镜组升幅较低（P〈0．05）；胸腔镜组术中出血量更少，住院时间、引流管留置时间均更短，术后下床活动时间更早，差异均有统计学意义（P〈0．05），手术时间差异无统计学意义（P〉0．05）；胸腔镜组术后CD3、CD4、CD8、CD4／CD8波动幅度更小（P〈0．05）；胸腔镜组28d生存率为2．63％，开胸手术组为5．00％，差异无统计学意义（P〉0．05）。结论胸腔镜治疗早期周围型肺癌与传统开胸术相比，具有效果显著、创伤小、恢复快的特点，值得推广。Objective To observe the effect of radical surgery thoraeoseope on TNF alpha,IL-6,IL-10 and the level of T lymphocyte subsets of patients with early peripheral lung cancer.Methods 78 patients with diagnosed early peripheral lung cancer in our hospital from August 2012 to December 2015 underwent surgery were included in the study and di- vided into open chest surgery group （n=40） and thoraeoscopie group （n=38）,patients in the open chest surgery group were treated with conventional thoracotomy,while patients in the thoraeoscopic group underwent thoracoscopic resection of early peripheral lung cancer.Change of TNF alpha,IL-6,IL-10 in two groups were compared,and general situation and the differenees in the levels of T lymphocyte subsets were compared.Results The level of TNF alpha,IL-6,IL-10 of two groups both improved （P〈0.05）,while change of thoracoscopic group was lower （P〈0.05）;intraoperative bleeding was less,hospitalization time,drainage tube indwelling time in the thoraeoscopic group was shorter,postoperative am- bulation time was earlier, and the differences were statistically significant （P〈0.05）,there was no statistically significant differences in operative time （P〉0.05）;fluctuation amplitude of CD3,CD4,CD8,CD4/CD8 were smaller in the thoraco- scopie group （P〈0.05）;survival rate of 28 d in the thoracoseopic group was 2.63%,with 5.00% in the open chest surgery group,and the difference was not statistically significant （P〉0.05）.Conclusion Compared with conventional thoracotomy, thoraeoscopie resection has the characteristics of obvious curative effect,less trauma and quick recovery.It is worth popu- larizing.

关 键 词：胸腔镜 早期周围型肺癌 根治术 炎症因子 T淋巴亚群水平 影响 

分 类 号：R734.2[医药卫生—肿瘤]