腹腔镜下结直肠癌根治术对结直肠癌患者的疗效及对细胞因子水平和免疫功能的影响  

Efficacy of laparoscopic radical resection for colorectal cancer and its effect on cytokine and immune function

作　　者：潘建生[1] 陈一杰[1] 张诚华[1] PAN Jiansheng;CHEN Yijie;ZHANG Chenghua(Department of General Surgery, the 910^th Hospital of Joint Logistic Support Force of People’s Liberation Army, Quanzhou 362000, Fujian,China)

机构地区：[1]中国人民解放军联勤保障部队第九一〇医院普通外科,福建泉州3620000

出　　处：《癌症进展》2018年第14期1782-1785,共4页Oncology Progress

摘　　要：目的探讨腹腔镜下结直肠癌根治术对结直肠癌患者的治疗效果及对细胞因子和免疫功能的影响。方法选取90例结直肠癌患者作为观察对象,根据随机数字表法将患者分为开腹组和腹腔镜组,每组45例。观察两组患者的手术相关指标,比较两组患者手术前后的细胞因子水平、免疫功能、胃肠功能以及并发症的发生率。结果腹腔镜组患者的手术时间明显短于开腹组患者,术中出血量明显少于开腹组患者,术后视觉模拟评分(VAS)明显低于开腹组患者(P﹤0.01)。术后,两组患者的C反应蛋白(CRP)、白细胞介素-18(IL-18)和白细胞介素-6(IL-6)水平均低于本组术前(P﹤0.05),且腹腔镜组患者的CRP、IL-18和IL-6水平均明显低于开腹组患者(P﹤0.01)。术后,两组患者的免疫球蛋白G(IgG)、免疫球蛋白A(IgA)和免疫球蛋白M(IgM)水平均低于本组术前,且腹腔镜组患者的IgG、IgA和IgM水平均高于开腹组患者(P﹤0.05)。术后,腹腔镜组患者的肠鸣音恢复时间、排气时间、进食时间和排便时间均明显短于开腹组患者(P﹤0.01)。结论腹腔镜下结直肠癌根治术对结直肠癌有较好的治疗效果,可明显改善患者的细胞因子水平和免疫功能,具有良好的应用价值。Objective To observe the efficacy of laparoscopic radical resection for colorectal cancer and its effect on cytokine and immune function.Method Ninety patients with colorectal cancer were analyzed,and randomly divided into laparotomy group(n=45)and laparoscopy group(n=45).The related operative parameters of the two groups were observed,and the cytokines level,immune function,gastrointestinal function and the incidence of complications were compared before and after operation.Result The operation time of patients in the laparoscopy group was significantly shorter than that of patients in the laparotomy group,the intraoperative blood loss of patients in the laparoscopy group was significantly less than that of patients in the laparotomy group,and the postoperative VAS score of patients in the laparoscopy group was significantly lower than that of patients in the laparotomy group(P<0.01).After operation,the levels of Creactive protein(CRP),interleukin-18(IL-18)and interleukin-6(IL-6)of patients in both group were lower than those before the operation(P<0.05),and the levels of CRP,IL-18and IL-6of patients in the laparoscopy group were lower than those of patients in the laparotomy group(P<0.01).After operation,the levels of immunoglobulin G,immunoglobulin A and immunoglobulin M of patients in both group were significantly lower than those before operation,and the levels of IgG,IgA and IgM of patients in the laparoscopy group were significantly higher than those of patients in the laparotomy group(P<0.05).After operation,the recovery time of bowel sound,exhaustion,eating and defecation of patients in the laparoscopy group were all significantly shorter than those of patients in the laparotomy group(P<0.01).Conclusion Laparoscopic radical resection has a good therapeutic effect on colorectal cancer,which can significantly improve the cytokine and immune function of patients,and has good application value.

关 键 词：结直肠癌 腹腔镜 细胞因子 免疫功能 胃肠功能 

分 类 号：R735.3[医药卫生—肿瘤]