右半结肠癌患者腹腔镜中间入路手术的疗效及免疫状况分析  

Efficacy and immune status of laparoscopic surgery in patients with right colon cancer

作　　者：梁元晓 孙锞 LIANG Yuanxiao,SUN Ke(Xinchang Hospital Affiliated to Wenzhou Medical University, Zhejiang 312500, Chin)

机构地区：[1]温州医科大学附属新昌医院,绍兴312500

出　　处：《浙江创伤外科》2018年第2期210-212,共3页Zhejiang Journal of Traumatic Surgery

摘　　要：目的探究右半结肠癌患者腹腔镜中间入路手术的疗效及免疫状况。方法选择2015年3月至2017年6月来本院就诊的50例右半结肠癌患者,经过随机数表法均分为对照组和观察组,每组25例。对照组采用开腹治疗,观察组采用腹腔镜中间入路手术进行治疗。对两组患者术中、术后相关指标,CD3^+、CD4^+、CD8^+T淋巴细胞等免疫指标进行对比分析。同时,对两组术后右半肠癌活力指标,并发症发生率进行对比分析。结果观察组术中的出血量及手术所用时间显著少于对照组(P<0.05),但淋巴结清除的数目无显著差异(P>0.05);术后,观察组镇痛、排气及住院时间显著少于对照组(P<0.05)。术前,两组患者CD3^+、CD4^+、CD8^+T淋巴细胞及CD4^+/CD8^+比值无显著差异(P>0.05);术后,观察组CD3^+、CD4^(++)T淋巴细胞及CD4^+/CD8^+比值显著提高,与对照组具有显著差异(P<0.05)。CD8^+T淋巴细胞含量显著降低,与对照组具有显著差异(P<0.05)。术后,观察组血清Polo样激酶-1(Serum Polo-like kinase-1,Plk1)、胸腺激酶(Thymidine kinase,TK1)、凋亡抑制因子(Apoptosis inhibitor,Livin X)、连锁凋亡抑制蛋白(Apoptosis inhibitor protein,Xiap)等主要的右半肠癌活力指标显著低于对照组(P<0.05)。观察组切口感染、尿路感染等并发症发生率显著低于对照组(P<0.05)。结论腹腔镜中间入路手术具有良好的治疗右半结肠癌效果,显著减少术中出血量、缩短手术及术后恢复时间,明显改善CD3^+、CD4^+等免疫细胞百分比,减低患者体内右半肠癌活力指标及并发症发生,值得在临床上广泛推广。Objective To investigate the efficacy and immune status of laparoscopic surgery in patients with right-sided colon cancer.Methods 50 patients with right colon cancer who came to our hospital from March 2015 to June 2017, were randomly divided into control group and observation group with 25 cases in each group. The patients in the control group was treated by laparotomy, and in the observation group was treated by laparoscopic middle-section approach. Intraoperative and postoperative related indicators, CD3＋, CD4＋, CD8＋and other immune parameters were compared between the two groups. At the same time, the comparative analysis of the vitality index and the complication rate of right colon cancer after operation were compared between the two groups. Results The intraoperative blood loss and operation time in the observation group were significantly less than those in the control group（P〈0.05）, but there was no significant difference in the number of lymph nodes dissection between the ob-servation group and the observation group（P〈0.05）.The analgesiatime, exhaust time and length of stay in the observation group were Less than those in the control group（P〈0.05）. There was no significant difference in the ratio of CD3＋, CD4＋, CD8＋T lymphocytes and CD4＋/CD8＋between the two groups before surgery（P〉0.05）. The ratio of CD3＋, CD4＋T lymphocytes and CD4＋/CD8＋There was significant difference with the control group（P〈0.05）. CD8＋T lymphocytes decreased significantly（P〉0.05） compared with the control group. After operation, Serum Polo-like kinase-1（Plk1）,Thymidine kinase（TK1）, Apoptosis inhibitor（Livin X）, Apoptosis inhibitor protein,（Xiap） and other major indicators of right-sided cancer activity was significantly lower than the control group（P〈0.05）. The incidence of incision infection and urinary tract infection in observation group was significant-ly lower than that in control group（P〈0.05）. Conclusion Laparoscopic surgery has a good ef

关 键 词：右半结肠癌 腹腔镜 中间入路 并发症 

分 类 号：R657.2[医药卫生—外科学]