单孔腹腔镜腹会阴联合Miles手术对直肠癌患者机体免疫功能影响的临床研究  

Clinical Study of Influence of Single Port Laparoscopic Peritoneal Perineal Combined with Miles Surgery on Immune Function in Patients with Rectal Cancer

作　　者：陈晓[1] 郑小明[1] 张清[1] 冯平[1] CHEN Xiao;ZHENG Xiaoming;ZHANG Qing;FENG Ping(The First People’s Hospital of Zhaoqing,Zhaoqing 526000,China;不详)

机构地区：[1]肇庆市第一人民医院,广东肇庆526000

出　　处：《中外医学研究》2022年第6期104-107,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

基　　金：肇庆市科技创新指导类项目(201804030830)。

摘　　要：目的:探究直肠癌患者采用单孔腹腔镜腹会阴联合直肠癌根治术(Miles手术)对其机体免疫功能的影响。方法:选取2017年7月-2021年4月在肇庆市第一人民医院治疗的60例直肠癌患者,按照随机数字表法分成观察组和对照组,每组30例,对照组给予常规开腹经会阴联合Miles治疗,观察组给予单孔腹腔镜腹会阴联合Miles手术治疗。比较两组血清补体C3、C4含量、免疫功能指标及免疫球蛋白水平。结果:术后24 h,两组C3、C4水平均高于术前,差异均有统计学意义(P<0.05);术后72 h,观察组C3、C4水平与术前比较,差异均无统计学意义(P>0.05),术后72 h,观察组C3、C4水平均低于术后24 h,差异均有统计学意义(P<0.05)。对照组术后72 h的C3、C4水平均高于术前,但低于术后24 h,差异均有统计学意义(P<0.05)。观察组术后24、72 h的C3、C4水平均低于对照组,差异均有统计学意义(P<0.05)。术后3 d,两组CD4^(+)、CD4^(+)/CD8^(+)均低于术前,CD8^(+)均高于术前,但观察组CD4^(+)、CD4^(+)/CD8^(+)均高于对照组(P<0.05),CD8^(+)低于对照组,差异均有统计学意义(P<0.05)。术后两组IgA、IgG、IgM水平均低于术前,但观察组均高于对照组,差异均有统计学意义(P<0.05)。结论:对直肠癌患者采用单孔腹腔镜腹会阴联合Miles手术可有效提高患者免疫功能,值得进行临床推广。Objective:To explore the effect of single-port laparoscopic peritoneal perineal combined with radical rectal cancer resection (Miles surgery) on immune function in patients with rectal cancer.Method:A total of 60 patients with rectal cancer treated in the First People’s Hospital of Zhaoqing from July 2017 to April 2021 were selected,they were divided into observation group and control group according to the random number table method,30 cases in each group.The control group received conventional laparotomy combined with Miles,the observation group was treated with single-port laparoscopic peritoneal perineal combined with Miles surgery.Serum complement C3,C4 content,immune function index and immunoglobulin level were compared between two groups.Result:At 24 h after surgery,C3 and C4 levels in both groups were higher than those before surgery,the differences were statistically significant (P<0.05).72 h after surgery,there were no significant differences in C3 and C4 levels between the observation group and those before surgery (P>0.05);72 h after surgery,C3 and C4 levels in the observation group were lower than those at 24 h after surgery,the differences were statistically significant (P<0.05).The levels of C3 and C4 in the control group at 72 h after surgery were higher than those before surgery,but lower than those at 24 h after surgery,the differences were statistically significant (P<0.05).The C3 and C4 levels in the observation group were lower than those in the control group 24 and 72 h after surgery,the differences were statistically significant (P<0.05).3 d after surgery,CD4^(+)and CD4^(+)/CD8^(+)in both groups were lower than those before surgery,and CD8^(+)was higher than that before surgery,but CD4^(+)and CD4^(+)/CD8^(+)in observation group were higher than those in control group (P<0.05),and CD8^(+)in observation group was lower than that in the control group,the differences were statistically significant (P<0.05).After surgery,the levels of IgA,IgG and IgM in both groups were lower than those before

关 键 词：单孔腹腔镜腹会阴术 直肠癌根治术 直肠癌 免疫功能 

分 类 号：R735.37[医药卫生—肿瘤]