两孔法腹腔镜结直肠癌根治术对结直肠癌患者血清应激指标及T淋巴细胞亚群的影响  

The Effect of Two Port Laparoscopic Radical Resection for Colorectal Cancer on Serum Stress Indicators and T Lymphocyte Subsets in Patients with Colorectal Cancer

作　　者：杨昕 乐奇 刘飞 曾文革 YANG Xin;LE Qi;LIU Fei;ZENG Wenge(Department of General Surgery,Jiangxi Province Hospital of Integrated Chinese and Western Medicine,Nanchang 330008,China;不详)

机构地区：[1]江西省中西医结合医院普外科,江西南昌330008

出　　处：《中国医学创新》2024年第30期64-68,共5页Medical Innovation of China

摘　　要：目的:探讨两孔法腹腔镜结直肠癌根治术(LRRC)在结直肠癌中的疗效。方法:回顾性分析2021年1月—2024年1月江西省中西医结合医院收治的84例结直肠癌患者临床资料,按手术方法不同分组,将接受常规多孔LRRC的42例设为对照组,将接受两孔法LRRC的42例设为观察组。比较两组手术情况、血清应激指标、T淋巴细胞亚群、肿瘤标志物、并发症。结果:观察组首次下床活动时间、首次排气时间及术后住院时间分别为(26.88±2.42)h、(40.25±4.35)h、(8.41±1.28)d,短于对照组的(34.68±3.57)h、(51.74±5.89)h、(11.05±1.34)d,差异均有统计学意义(P<0.05);观察组术后皮质醇、促肾上腺皮质激素、去甲肾上腺素水平分别为(759.65±55.82)nmol/L、(19.55±1.54)pmol/L、(87.14±5.59)μg/L,低于对照组的(824.28±66.07)nmol/L、(22.06±2.42)pmol/L、(99.52±6.83)μg/L,差异均有统计学意义(P<0.05);观察组术后CD4^(+)、CD4^(+)/CD8^(+)为(35.41±3.25)%、(1.19±0.21),高于对照组的(31.84±3.19)%、(1.00±0.19),CD8^(+)为(29.86±2.57)%,低于对照组的(31.89±2.87)%,差异均有统计学意义(P<0.05);两组术后肿瘤标志物水平、并发症发生率相比,差异均无统计学意义(P>0.05)。结论:两孔法LRRC治疗结直肠癌效果更佳,可降低手术应激反应,缩短术后下床活动、排气时间等,减轻创伤引起的免疫抑制,且安全性尚可。Objective:To investigate the efficacy of laparoscopic radical resection for colorectal cancer(LRRC)with two port technique in colorectal cancer.Method:A retrospective analysis was conducted on the clinical data of 84 patients with colorectal cancer admitted to Jiangxi Province Hospital of Integrated Chinese and Western Medicine from January 2021 to January 2024.According to different surgical methods,42 cases who received conventional porous LRRC were set as the control group,and 42 cases who received two port LRRC were set as the observation group.The surgical conditions,serum stress indicators,T lymphocyte subsets,tumor markers,and complications between two groups were compared.Result:The first time of getting out of bed,the first time of exhalation and the postoperative hospitalization time in the observation group were(26.88±2.42)hours,(40.25±4.35)hours and(8.41±1.28)days,respectively,which were shorter than(34.68±3.57)hours,(51.74±5.89)hours and(11.05±1.34)days in the control group,the differences were statistically significant(P<0.05);the postoperative levels of cortisol,adrenocorticotropic hormone and norepinephrine in the observation group were(759.65±55.82)nmol/L,(19.55±1.54)pmol/L,and(87.14±5.59)μg/L,which were lower than(824.28±66.07)nmol/L,(22.06±2.42)pmol/L,and(99.52±6.83)μg/L in the control group,with statistical significance(P<0.05);the postoperative CD4^(+)and CD4^(+)/CD8^(+)in the observation group were(35.41±3.25)%and(1.19±0.21),which were higher than(31.84±3.19)%and(1.00±0.19)in the control group,respectively,CD8^(+)was(29.86±2.57)%,which was lower than(31.89±2.87)%in the control group,with statistical significance(P<0.05);there were no statistically significant differences in the levels of tumor markers after surgery and complication rate between the two groups(P>0.05).Conclusion:Two port LRRC treatment is more effective in treating colorectal cancer,reducing surgical stress response,shortening the postoperative activity of getting out of bed,exhaust time,etc.,alleviating i

关 键 词：结直肠癌 两孔法腹腔镜结直肠癌根治术 应激指标 T淋巴细胞亚群 

分 类 号：R735.34[医药卫生—肿瘤]