腹腔镜与传统开腹手术对胃癌临床疗效、术后并发症及免疫功能的影响比较  

Comparison of the Influence of Laparoscopic and Traditional Open Surgery on the Clinical Effect, Postoperative Complications and Immunologic Functions of Patients with Gastric Cancer

作　　者：阚炳华 蔡磊[2] 燕归如 申武峰 应可明[1] 

机构地区：[1]汉中市中心医院肿瘤外科,陕西汉中723000 [2]第四军医大学西京消化病医院消化一科,陕西西安710032

出　　处：《现代生物医学进展》2017年第19期3742-3745,共4页Progress in Modern Biomedicine

摘　　要：目的:探讨腹腔镜与传统开腹手术治疗胃癌的临床疗效、安全性及对患者免疫功能的影响。方法:选择2012年3月至2014年3月在我院行胃癌D2根治术的胃癌患者92例并随机分为两组,开腹组(A组)44例接受传统开腹手术,腹腔镜组(B组)48例接受腹腔镜辅助胃癌根治术,观察和比较两组患者的手术情况以及手术前后患者免疫功能的变化,比较两组患者围术期不良反应的发生情况及临床疗效。结果:B组患者术中切口长度、出血量明显优于A组患者(P<0.05),且B组患者较A组患者术后排气时间以及疼痛缓解情况明显较好(P<0.05);两组患者接受手术前后,机体的免疫功能有所变化,B组患者术后24hCD3^+、CD4^+、CD8^+、CD4^+/CD8^+以及NK细胞相对活性等细胞免疫指标明显高于A组(P<0.05),体液免疫指标IgM、IgG以及IgA等免疫球蛋白明显高于A组;两组患者术中并发症的发生率差异无统计学意义(P>0.05),B组患者术后并发症的发生率与A组比较明显降低,且差异具有统计学意义(P<0.05)。结论:腹腔镜辅助胃癌D2根治术对胃癌患者术中临床疗效有显著改善作用,可降低对机体免疫功能的影响并提高治疗的安全性。Objective：To explore the influence of laparoscopic and traditional open surgery on the clinical effect,safety and immune function of patients with gastric cancer.Methods：92 patients of gastric cancer undergoing D2 radical resection were enrolled in our hospital from March 2012 to March 2014,in which patients were randomly divided into two groups：Group A （n=44） accepted traditional open surgery and Group B （n=48） adopted laparoscopic surgery.The clinical of surgery curative and immunologic functions were evaluated,and the adverse reactions in perioperative period were recorded and compared.Results：The operative incision lengths and bleeding of Group B were superior to those of Group B （P〈0.05）,and the postoperative exhaust time of Group B was shorter than that of Group A,the pain relief of Group B was better than that of Group A （P〈0.05）.The CD3^＋,CD4^＋,CD8^＋,CD4^＋/CD8^＋ and NK cell relative activity of cell immunity index was higher in Group B than those of Group A;the fluid immunity index of IgM,IgG and IgA in Group B were higher than those of Group A（P〈0.05）;no significant difference was observed in the intraoperative complications between two groups （P〉0.05）,and the incidence of postoperative complications in Group B was lower than that of Group A.Conclusions：Laparoscopic assisted D2 radical gastrectomy significantly improved the clinical curative of gastric cancer,decreased the impact on immune function and enhance the safety.

关 键 词：腹腔镜手术 胃癌 疗效 并发症 免疫功能 

分 类 号：R735.2[医药卫生—肿瘤]