腹腔镜与开腹直肠癌根治术对直肠癌患者机体炎症和免疫功能的影响  

Effects of Laparoscopic and Open Radical Resection of Rectal Carcinoma on Inflammation and Immune Function of Patients with Rectal Cancer

作　　者：莫琳 刘保荣[1] MO Lin;LIU Bao-rong(Department of General Surgery and Pediatrics,Xi'an Central Hospital,Xi'an 710007,China)

机构地区：[1]西安市中心医院普外儿科,西安710007

出　　处：《解放军医药杂志》2017年第12期28-31,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：陕西省自然科学研究计划项目(2014JM2-8182)

摘　　要：目的对比分析腹腔镜与开腹直肠癌根治术对直肠癌患者机体炎症和免疫功能的影响。方法纳入2014年3月—2016年12月收治的44例直肠癌患者的临床资料为研究对象。根据手术方式的不同分为观察组与对照组,每组22例。观察组行腹腔镜直肠癌根治术,对照组行开腹直肠癌根治术。于术前1 d、术后1、4、7 d分别测定T淋巴细胞亚群、自然杀伤T细胞(NKT)及自然杀伤细胞(NK),术前1 d和术后1 d检测白介素-6(IL-6)、IL-10,然后对比分析两组围术期情况。结果观察组术中出血量、术后肛门排气时间、进食时间及总住院时间均少于对照组(P<0.05)。术后1 d,两组IL-6水平低于术前1 d,IL-10水平高于术前1 d(P<0.05),且观察组变化幅度高于对照组(P<0.05)。术后1 d,两组CD3+、CD4+、CD8+、CD4+/CD8+、NKT细胞及NK细胞与术前1 d比较差异均有统计学意义(P<0.05),对照组变化幅度高于观察组(P<0.05)。观察组术后4、7 d的NK细胞高于对照组(P<0.05)。两组并发症发生率比较差异无统计学意义(P>0.05)。结论与开腹直肠癌根治术相比,腹腔镜直肠癌根治术对患者细胞免疫功能影响小、炎性反应弱,且创伤小、术后恢复快,是一种疗效安全可靠的微创手术方式。Objective To contrastively analyze effects of laparoscopic and open radical resection of rectal carcinoma on inflammation and immune function of patients with rectal cancer.Methods Clinical data of44patients with rectal cancer admitted during March2014and December2016was included in the study,and the patients were divided into observation group(n=22)and control group(n=22)according to different surgical methods.Observation group received laparoscopic radical resection,while control group received traditional open radical resection of rectal carcinoma.At preoperative1d and at postoperative1st,4th and7th d,T-lymphocyte subsets,natural killer T(NKT)cells and natural killer(NK)cells levels were detect.Levels of interleukin-6(IL-6)and IL-10were detected at preoperative1d and at postoperative1st d,and then intraoperative conditions were compared between two groups.Results Values of intraoperative intraoperative bleeding volume,postoperative anal exhaust time,eating time and total hospitalization time in observation group were significantly lower those in control group(P<0.05).At postoperative1st d,IL-6levels were significantly lower,while IL-10levels were significantly higher than those at preoperative1d in two groups(P<0.05),and the change ranges in observation group were significantly larger than those in control group(P<0.05).At postoperative1st d,the differences in CD3+,CD4+,CD8+,CD4+/CD8+,NKT and NK cells were significant higher compared with those at preoperative1d between two groups(P<0.05),and the change ranges in control group were significantly larger than those in observation group(P<0.05).NK cells levels at postoperative4th and7th d in observation group were significantly higher than those in control group(P<0.05).There was no significant difference in incidence rate of complications between two groups(P>0.05).Conclusion Compared with those by open radical resection of rectal carcinoma,laparoscopic radical resection of rectal carcinoma may achieve little effect on cellular immune function,less inflammatory

关 键 词：腹腔镜 开腹直肠癌根治术 直肠肿瘤 炎症 免疫 

分 类 号：R735.37[医药卫生—肿瘤]