腹腔镜直肠癌根治术对患者炎症反应、免疫功能及并发症的影响  

Effect of laparoscopic radical resection of rectal cancer on inflammatory response,immune function and complications

作　　者：蔡楚东[1] 周俊怿[1] 柯斌杰 CAI Chu-dong;ZHOU Jun-yi;KE Bin-jie(Department of General SurgeryⅡ,1.Shantou Central Hospital,Shantou 515031;Nan ao People's Hospital,Shantou 515900,Guangdong,China)

机构地区：[1]汕头市中心医院普外二科,广东汕头515031 [2]南澳县人民医院普外科,广东汕头515900

出　　处：《川北医学院学报》2021年第5期599-602,共4页Journal of North Sichuan Medical College

基　　金：广东省汕头市科技计划项目(汕府科)[(2017)119号-29]。

摘　　要：目的:探究腹腔镜直肠癌根治术对患者炎症反应、免疫功能及并发症的影响。方法:回顾性分析110例直肠癌根治术患者的临床资料,55例采用腹腔镜直肠癌根治术(腹腔镜组),55例接受开腹直肠癌根治术(开腹组)。比较两组患者手术情况、炎症反应、T淋巴细胞亚群水平及并发症发生情况。结果:腹腔镜组手术时间较开腹组增加,其术中出血量、住院天数、肠鸣音恢复时间及肛门排气时间较开腹组减少(P<0.05)。术后,两组肿瘤坏死因子(TNF-α)、白介素6(IL-6)、C-反应蛋白(CRP)、CD8^(+)水平均高于术前(P<0.05),CD4^(+)、CD4^(+)/CD8^(+)水平均低于术前(P<0.05);且腹腔镜组上述指标的变化程度及并发症发生率均低于开腹组(P<0.05)。结论:腹腔镜直肠癌根治术对患者机体炎症反应及免疫功能影响小,具有微创、肠道功能恢复较好及并发症发生率较低等优势。Objective:To investigate the effects of laparoscopic radical resection of rectal cancer on inflammatory response,immune function and complications.Methods:Clinical data of 110 patients undergoing radical resection of rectal cancer were retrospectively analyzed.55 patients received laparoscopic radical resection of rectal cancer(laparoscopic group),and 55 patients received open radical resection of rectal cancer(open group).The surgical situation,inflammatory response,T lymphocyte subsets and complications were compared between the two groups.Results:Compared with the open group,the operative time of the laparoscopic group was increased,and the intraoperative blood loss,hospital stay,bowel sound recovery time and anal exhaust time were decreased(P<0.05).After surgery,the levels of tumor necrosis factor(TNF-α),interleukin 6(IL-6),C-reactive protein(CRP)and CD8^(+)in two groups were higher than those before surgery(P<0.05),and the levels of CD4^(+)and CD4^(+)/CD8^(+)were lower than those before surgery(P<0.05).The changes of the above indexes and the incidence of complications in the laparoscopic group were lower than those in the open group(P<0.05).Conclusion:Laparoscopic radical resection of rectal cancer has little effect on the inflammatory response and immune function of patients,and has the advantages of minimally invasive surgery,good intestinal function recovery and low complications.

关 键 词：直肠癌 腹腔镜根治术 开腹根治术 炎症反应 免疫功能 并发症 

分 类 号：R735.3[医药卫生—肿瘤]