不同手术方式治疗老年结肠癌的临床疗效与细胞免疫状态比较  

Comparison of clinical efficacy and cellular immune status of different surgical methods in the treatment of elderly patients with colon cancer

作　　者：苏超云[1] 魏庆忠[1] 王钢[1] 任谊 郭雯 Su Chaoyun;Wei Qinzhong;Wang Gang;Ren Yi;Guo Wen(Beijing aerospace general hospital Beijing 100076)

机构地区：[1]北京航天总医院

出　　处：《中华普外科手术学杂志（电子版）》2019年第3期287-289,共3页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

摘　　要：目的 比较腹腔镜与开腹手术治疗老年结肠癌的并发症、细胞免疫状态及预后情况。方法回顾性分析2014年8月至2017年12月间收治的103例结肠癌老年患者资料,随机分为腹腔镜组(52例)和开腹组(51例),分别给予腹腔镜手术和开腹手术。比较两组患者的并发症发生率、细胞免疫功能及预后情况等指标。数据处理应用统计学软件SPSS22.0完成,并发症发生率采用χ2检验;细胞免疫指标及预后指标等数据用(x±s)来表示,组间比较采用独立t检验,P<0.05为差异存在统计学意义。结果腹腔镜组并发症发生率为5.8%(3/52)显著低于开腹组19.6%(10/51),(χ^2=4.5,P<0.05);术后两组患者的CD3、CD4、CD4/CD8均低于术前(均P<0.05),CD8高于术前(P<0.05);且腹腔镜组的CD3、CD4、CD4/CD8均高于开腹组(均P<0.05),CD8低于开腹组(P<0.05);与开腹组比较,腹腔镜组患者术后止痛药时间短、胃肠功能恢复快、进流质时间早、下床活动时间早、留置导管时间短、住院时间短(均P<0.05)。结论腹腔镜下结肠癌根治术与传统开腹手术相比,能有效降低并发症发生率,对细胞免疫功能的影响较小,缩短术后胃肠道功能恢复时间、下床活动时间及住院时间,有利于患者的预后,符合快速康复的外科理念,值得推广应用。Objective To compare the clinical efficacy and cellular immune status of laparoscopy and laparotomy in the treatment of elderly patients with colon cancer. Methods Clinical data of 103 elderly patients with colon cancer from August 2014 to December 2017 treated in our hospital were selected, and the patients were divided into laparoscopic group (52 cases) and laparotomy group (51 cases) according to the different methods. The incidence of complications, cellular immune function, and prognosis were compared between the two groups. Results The incidence of complications in laparoscopic group was significantly lower than that in laparotomy group,the differences were statistically significant ( P <0.05);After treatment, CD3, CD4, and CD4/CD8 in both groups were lower than before ( P <0.05), and CD8 was higher than before ( P <0.05), and CD3, CD4, CD4/CD8 in laparoscopic group were higher than those in laparotomy group ( P <0.05), CD8 in laparoscopic group was lower than that in the laparotomy group ( P <0.05);Compared with the laparotomy group, patients in the laparoscopic group had shorter postoperative analgesics, more rapid recovery of gastrointestinal function, earlier fluid intake time, earlier ambulation, shorter indwelling catheterization time, and shorter hospitalization time (all P <0.05). Conclusion Compared with traditional laparotomy surgery, laparoscopic radical resection of colon cancer can effectively reduce the incidence of complications, it has little effect on patient’s cellular immune function , it can shorten the recovery time of the postoperative gastrointestinal function, ambulation activity time and hospitalization time, it is beneficial to the prognosis of patients and is consistent with the concept of rapid recovery surgery, it is worthy of promotion and application.

关 键 词：结肠肿瘤 老年人 腹腔镜 免疫 细胞 预后 

分 类 号：R735.35[医药卫生—肿瘤]