腹腔镜根治术对高龄结直肠癌患者T淋巴细胞及血清皮质醇水平的影响  

Influence of laparoscopic radical surgery on T lymphocytes and serum cortisol levels in elderly patients with colorectal cancer

作　　者：姚磊 郝顺心[1] 张晶[1] YAO Lei;HAO Shun-xin;ZHANG Jing(Department of Gastrointestinal Surgery,Tianyou Hospital Affiliated to Wuhan University of Science and Technology,Hubei Province,Wuhan 430000,China)

机构地区：[1]武汉科技大学附属天佑医院胃肠外科,湖北武汉430000

出　　处：《中国当代医药》2020年第17期96-98,102,共4页China Modern Medicine

摘　　要：目的探讨腹腔镜根治术对高龄结直肠癌患者T淋巴细胞及血清皮质醇水平的影响。方法选择2017年5月~2019年6月我院收治的90例高龄结直肠癌患者,按随机数字表法分为试验组与对照组,各45例。试验组行腹腔镜根治术,对照组行开腹手术。比较两组的围术期指标、血清皮质醇水平、T淋巴细胞水平及并发症总发生率。结果两组的手术用时比较,差异无统计学意义(P>0.05);试验组的术中失血量少于对照组,住院时间、进食时间和肛门排气时间短于对照组,差异有统计学意义(P<0.05);试验组的皮质醇水平、CD3^+、CD4^+、CD4^+/CD8^+水平分别为(11.43±3.09)μg/ml、(54.19±6.68)%、(34.21±4.88)%、1.13±0.25,对照组分别为(15.28±2.76)μg/ml、(48.26±6.09)%、(29.15±5.04)%、0.97±0.27,两组比较差异有统计学意义(P<0.05);两组术后的CD8^+水平比较,差异无统计学意义(P>0.05);试验组的术后并发症总发生率为4.44%,低于对照组的22.22%,差异有统计学意义(P<0.05)。结论腹腔镜根治术治疗高龄结直肠癌患者安全性较高,能有效减少术中失血量,缓解应激反应,调节机体免疫功能,缩短术后恢复时间。Objective To investigate the influence of laparoscopic radical surgery on T lymphocytes and serum cortisol levels in elderly patients with colorectal cancer.Methods A total of 90 elderly patients with colorectal cancer who were admitted to our hospital from May 2017 to June 2019 were enrolled in the study.They were divided into the experimental group and the control group according to the random number table methods,45 cases in each group.The experimental group underwent laparoscopic radical surgery,and the control group underwent open surgery.Perioperative indicators,serum cortisol levels,the level of T lymphocytes and the total incidence of complication were compared between the two groups.Results There was no significant difference in operation time between the two groups(P>0.05).The blood loss in the experimental group was lower than that in the control group,the hospitalization time,feeding time and anus exhaust time in the experimental group were shorter than those in the control group,the differences were statistically significant(P<0.05).The levels of cortisol,CD3^+,CD4^+,CD4^+/CD8^+in the experimental group were(11.43±3.09)μg/ml,(54.19±6.68)%,(34.21±4.88)%,1.13±0.25,which in the control group were(15.28±2.76)μg/ml,(48.26±6.09)%,(29.15±5.04)%,0.97±0.27,the differences were statistically significant(P<0.05).There was no significant difference in the level of postoperative CD8^+between the two groups(P>0.05).The total incidence of postoperative complications in the experimental group was 4.44%,which was lower than that in the control group(22.22%),the difference was statistically significant(P<0.05).Conclusion Laparoscopic radical operation is safe for patients with elderly colorectal cancer,which can effectively reduce intraoperative blood loss,relieve stress response,regulate immune function and shorten postoperative recovery time.

关 键 词：高龄结直肠癌 腹腔镜根治术 血清皮质醇 T淋巴细胞 

分 类 号：R735.3[医药卫生—肿瘤]