腹腔镜结直肠癌手术对患者高凝状态及免疫功能的影响  

Effect of laparoscopic surgery on hypercoagulable state and immune function in patients with colorectal cancer

作　　者：王辉[1] 谢荣俊[1] 李峰[1] 刘龙飞[1] 易世杰[1] Hui Wang;Rong-jun Xie;Feng Li;Long-fei Liu;Shi-jie Yi(Department of Gastrointestinal Surgery,the Affiliated Nanhua Hospital,University of South China,Hengyang,Hunan 421002,China)

机构地区：[1]南华大学附属南华医院胃肠外科,湖南衡阳421002

出　　处：《中国现代医学杂志》2018年第27期103-106,共4页China Journal of Modern Medicine

摘　　要：目的研究腹腔镜和开腹手术对结直肠癌患者高凝状态及免疫功能的影响。方法收集2013年2月-2015年8月该院行结直肠癌手术的121例患者作为研究对象。其中行腹腔镜下手术73例(腹腔镜组),行开腹手术48例(开腹组);比较两组手术前后高凝状态指标D-二聚体(D-D)、凝血酶原片段_(1+2)(F_(1+2))、蛋白C(Pro-C)和细胞免疫指标CD3^+、CD4^+及CD8^+。结果与同组术前比较,术后开腹组CD3^+呈下降趋势(t=-7.419,P=0.000),而腹腔镜组CD3^+无变化(t=-0.218,P=0.901);与开腹组术后比较,腹腔镜组术后D-D值呈升高趋势(t=2.312,P=0.018),Pro-C值无变化(t=0.180,P=0.941)、F_(1+2)与CD4^+值降低幅度较小(t=3.827和5.930,P=0.000和0.008)、CD8^+值升高幅度缓慢(t=-9.094,P=0.000)。结论腹腔镜手术是结直肠癌治疗的有效手术方式,但容易造成血液高凝状态,围手术期间应采取必要的预防措施。Objective To study the effect of laparoscopic surgery and open operation on hypercoagulable state and immune function in patients with colorectal cancer.Methods The clinical data of 121 colorectal cancer patients who underwent Colorectal cancer surgery in our Hospital from Feburay 2013 to August 2015 were collected.There were 73 cases with laparoscopic surgery,and 48 cases with open operation.The indicators of hypercoagulable state(D-dimer,Prothrombin Fragment 1 and 2,Protein C)and immune function(CD3+,CD4+,CD8+)were compared before and after surgery between two groups.Results Compared with the preoperative period,the level of CD3+was decreased postoperatively in the open operation group(t=-7.419,P=0.000),while there was no such significant change in the laparoscopic group(t=-0.218,P=0.901).Compared with the open operation group,the increase of D-D was significantly higher after surgery in the laparoscopic group,but the Pro-c value was not significantly changed;F1+2 and CD4+decreased slightly and CD8+increased slowly in the laparoscopy group.Conclusions Laparoscopic surgery is an effective method for colorectal cancer treatment,but it is easy to cause hypercoagulable state of blood.Necessary preventive measures should be taken during the perioperative period.

关 键 词：结直肠癌 高凝状态 免疫功能 

分 类 号：R619[医药卫生—外科学]