腹腔镜下根治术对直肠癌患者胃肠功能和细胞免疫功能的影响  

Effect of Laparoscopic Radical Operation on Gastrointestinal Function and Cellular Immune Function in Rectal Cancer Patients

作　　者：刘宙[1] 王延明[1] 茆成祥[1] 

机构地区：[1]解放军第二五二医院普外科,河北保定071000

出　　处：《解放军预防医学杂志》2017年第6期667-669,共3页Journal of Preventive Medicine of Chinese People's Liberation Army

摘　　要：目的探讨腹腔镜下根治术对直肠癌患者胃肠功能和细胞免疫功能的影响。方法选取2013年10月-2014年6月本院胃肠外科收治确诊的50例直肠癌患者,按照患者手术方式不同,将患者分为腹腔镜组与开腹组。腹腔镜组(25例)采用腹腔镜下直肠癌根治术,开腹组(25例)采用常规开腹手术进行治疗。记录并比较2组患者手术前1 d、手术后3 d、7 d时的胃肠功能水平及细胞免疫功能。结果腹腔镜组手术用时多于开腹手术组(P<0.01);腹腔镜组手术中出血量低于开腹组(P<0.01);腹腔组手术后进食时间、肠鸣音恢复时间、手术后排气时间、住院时间均优于开腹组,感染情况发生率低于开腹组(P<0.01)。在手术后3 d、7 d时,腹腔镜组CD_3^+、CD_4^+、CD_8^+、NK水平较开腹组高(P<0.05);两组患者手术后3 d的CRP水平均有上升,至手术后7 d CRP呈下降趋势,同一时间点钟腹腔镜组CRP水平均低于开腹组(P<0.05)。结论腹腔镜下直肠癌根治术出血少、住院时间短,对机体免疫系统功能影响较小,更有利于直肠癌患者胃肠功能的及时恢复。Objective To investigate the effects of laparoscopic radical gastrectomy on gastrointestinal function and cellu- lar immune function in patients with rectal cancer. Methods A total of 50 patients with rectal cancer admitted to our hospital between October 2013 to June 2014 were divided into the laparoscopic group and laparotomic group according to different surgical procedures. The laparoscopic group （25 cases） underwent laparoscopic radical resection of rectal cancer while the laparotomic group （25 cases） was treated with conventional open surgery. Gastrointestinal function and cellular immune function were recor- ded and compared between the two groupsl day before operation,3 d and 7 d after operation. Results The time taken by surgery in the laparoscopic group was longer than that of the laparotomic group （ P〈0. 01 ）. The blood loss of the laparoscopic group was be- low that of the laparotomic group （P〈0. 01 ）. The time of feeding, the recovery time of bowel sounds, the time of venting after op- eration and the length of hospital stay in the laparoscopic group were better than those of the laparotomic group. The incidence of infections was lower than in the laparotomic group （ P〈0. 01 ）. The levels of CD3＋, CD4＋, CD8 ＋ and NK in the laparoscopic group were higher than those in the laparotomic group at 3 d and 7 d after operation （P〈0.05）. CRP levels increased at 3 d after operation but decreased at 7 d after operation. CRP levels in the laparoscopic group were lower than those in the laparotomic group at the same time （P〈0.05）. Conclusion Laparoscopic radical resection of rectal cancer is followed by less bleeding and shorter hospital stay, has less influence on the immune system function, and is more conducive to the recovery of gastrointestinal functions among rectal cancer patients.

关 键 词：直肠癌 胃肠功能 细胞免疫功能:腹腔镜 

分 类 号：R735.37[医药卫生—肿瘤]