腹腔镜与开腹手术对进展期胃癌患者围手术期疗效及免疫功能的影响  

Influence of Laparoscopy and Open Surgery on Perioperative Efficacy and Immune Function in the Treatment of Patients with Gastric Cancer in Progression

作　　者：罗庆伟[1] 李志红[1] 刘黎明[1] 何建林[1] 汤俊[1] 孙静[1] 周志军[1] LUO Qing-wei LI Zhi-hong LIU Li-ming HE Jian-lin TANG Jun SUN Jing ZHOU Zhi-jun(Second Department of General Surgery, Ezhou Hospital of People＇s Hospital of Wuhan University/Ezhou Central Hospital, Ezhou, Hubei, 436000, Chin)

机构地区：[1]武汉大学人民医院鄂州医院/鄂州市中心医院普外二科,湖北鄂州436000

出　　处：《现代生物医学进展》2017年第20期3921-3924,共4页Progress in Modern Biomedicine

摘　　要：目的:研究腹腔镜与开腹手术对进展期胃癌患者围手术期疗效及免疫功能的影响。方法:选择从2015年9月到2016年8月在医院治疗的进展期胃癌患者124例作为研究对象,依照简单数字随机表法将患者分成观察组以及对照组各含62例,对观察组进行腹腔镜辅助手术,对照组则给予开腹手术,对比两组围术期疗效相关指标,手术前后的免疫功能指标CD4^+、CD8^+及CD4^+/CD8^+),以及两组术后的并发症。结果:观察组的手术时间明显长于对照组,且切口长度、出血量少于对照组,住院时间和术后排气时间均较对照组短,差异有统计学意义(P<0.05)。术后两组CD4^+、CD4^+/CD8^+水平均较术前明显降低,而CD8^+水平明显上升,且术后观察组CD4^+、CD4^+/CD8^+水平均显著高于对照组,差异有统计学意义(P<0.05)。术后观察组并发症的总发生率是4.84%,明显低于对照组的16.13%,差异有统计学意义(P<0.05)。结论:利用腹腔镜手术治疗进展期胃癌,具有较好的疗效,且对患者免疫功能产生的影响较小,安全性较高,值得给予推广。Objective：To study perioperative efficacy and immune function influence of laparoscopy and open surgery in the treatment of patients with gastric cancer during progressive stage.Methods：124 patients with gastric cancer during progressive stage were selected as study subjects who were treated in the hospital from September 2015 to August 2016.The patients were divided into observation group and control group with 62 cases in each group according to the simple digital random table method,the observation group were treated by laparoscopy assisted surgery,while the control group was given open surgery,compared the perioperative effect related indexes in two groups,the indexes of immune function before and after surgery （CD4＋,CD8＋ and CD4＋/CD8＋）,as well as the postoperative complications in two groups.Results：The operation time of the observation group was significantly longer than that of the control group,but the incision length,blood loss volume,and postoperative exhaust time,length of stay time were significantly less than that of the control group,the differences were statistically significant （P＜0.05）.The CD4＋ and CD4＋/CD8＋ levels in two groups after operation were significantly lower than before operation,CD8＋ level was significantly higher than before operation,and the CD4＋ and CD4＋/CD8＋ levels in the observation group after operation were significantly higher than those in the control group,the differences were statistically significant （P＜0.05）.The total incidence rate of postoperative complications in the observation group was 4.84％,which was significantly lower than 16.13％ in control group,the difference was statistically significant （P＜0.05）.Conclusion：Laparoscopy surgery has a good curative effect in the treatment of patients with gastric cancer during progressive stage,with less influence on the immune function,and high safety,it is worth to be popularized.

关 键 词：腹腔镜 开腹手术 胃癌 进展期 疗效 免疫功能 

分 类 号：R735.2[医药卫生—肿瘤]