[1]于秀芝.腹腔镜结直肠癌根治术与开腹结直肠癌根治术对结直肠癌患者术后炎症反应及免疫功能的影响比较[J].新乡医学院学报,2019,36(5):471-474.[doi:10.7683/xxyxyxb.2019.05.017]
　YU Xiu-zhi.Comparison of the effect between laparoscopic radical resection and open radical resection of colorectal cancer on postoperative inflammatory response and immune function[J].Journal of Xinxiang Medical University,2019,36(5):471-474.[doi:10.7683/xxyxyxb.2019.05.017]
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腹腔镜结直肠癌根治术与开腹结直肠癌根治术对结直肠癌患者术后炎症反应及免疫功能的影响比较
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
36
期数:
2019年5
页码:
471-474
栏目:
临床研究
出版日期:
2019-05-05

文章信息/Info

Title:
Comparison of the effect between laparoscopic radical resection and open radical resection of colorectal cancer on postoperative inflammatory response and immune function
作者:
于秀芝
（驻马店市中心医院肛肠科，河南　驻马店　463000）
Author(s):
YU Xiu-zhi
（Department of Anorectal Diseases，Zhumadian Central Hospital，Zhumadian 463000，Henan Province，China）
关键词:
结直肠癌; 腹腔镜手术; 开腹手术; 炎症反应; 免疫功能
Keywords:
colorectal cancer; laparoscopic operation; laparotomy; inflammatory reaction; immune function
分类号:
R735.3
DOI:
10.7683/xxyxyxb.2019.05.017
文献标志码:
A
摘要:
目的　比较腹腔镜结直肠癌根治术与开腹结直肠癌根治术对结直肠癌患者术后炎症反应和免疫功能的影响。方法　选择2016年1月至2018年3月驻马店市中心医院收治的80例结直肠癌患者为研究对象，按照手术方式分为观察组和对照组，每组40例。观察组患者采取腹腔镜结直肠癌根治术，对照组患者采取传统开腹结直肠癌根治术。记录2组患者的手术时间、术中出血量、切口长度、术后肛门排气时间、淋巴结清扫数目及住院时间；分别于手术前和手术后第2天采用酶联免疫吸附法检测患者血清C反应蛋白（CRP）、白细胞介素-6（IL-6）及肿瘤坏死因子（TNF-α）水平，应用流式细胞仪检测外周血CD4+、CD8+、自然杀伤（NK）细胞水平，并计算CD4+与CD8+的比值（CD4+/CD8+）。结果　观察组患者术中出血量少于对照组，切口长度、术后肛门排气时间和住院时间短于对照组（P<0.05）；2组患者手术时间、淋巴结清扫数目比较差异无统计学意义（P>0.05）。2组患者术前血清CPR、IL-6及TNF-α水平比较差异均无统计学意义（P>0.05）；2组患者术后血清CPR、IL-6及TNF-α水平显著高于术前（P<0.05），术后观察组患者血清CPR、IL-6及TNF-α水平显著低于对照组（P<0.05）。2组患者术前外周血CD4+、CD8+、CD4+/CD8+及NK细胞水平比较差异均无统计学意义（P>0.05）。2组患者术后外周血CD4+、CD4+/CD8+、NK细胞水平显著低于术前，CD8+水平显著高于术前（P<0.05）；术后观察组患者外周血CD4+、CD4+/CD8+、NK细胞水平显著高于对照组，CD8+水平显著低于对照组（P<0.05）。结论　与开腹结肠癌根治术相比，腹腔镜结肠癌根治术具有创伤小、出血量少、机体炎症反应轻、患者术后恢复快等优点，且对患者免疫功能影响小。
Abstract:
Objective　To compare the effect between laparoscopic radical resection and open radical resection of colorectal cancer on postoperative inflammatory response and immune function.Methods　Eighty patients with colorectal cancer admitted to Zhumadian Central Hospital from January 2016 to March 2018 were selected as the study subjects.The patients were divided into observation group and control group according to the operation method，with 40 cases in each group.The patients in the observation group were performed with laparoscopic radical resection of colorectal cancer，while the patients in the control group were performed with traditional open resection of colorectal cancer.The operation time，intraoperative bleeding volume，incision length，postoperative anal exhaust time，the number of lymph node dissection and hospitalization time were recorded.The levels of serum C-reactive protein （CRP），interleukin-6 （IL-6） and tumor necrosis factor-α（TNF-α） were detected by enzyme linked immunosorbent assay before and the second day after operation.The levels of CD4+，CD8+，natural killer （NK） cells in peripheral blood were measured by flow cytometry，and the ratio of CD4+ to CD8+ （CD4+/CD8+） was calculated.Results　Compared with the control group，the intraoperative bleeding volume was more，and the incision length，postoperative anal exhaust time and hospitalization time was shorter in the observation group （P<0.05）.There was no significant difference in operation time and the number of lymph node dissection between the two groups （P>0.05）.There was no significant difference in the levels of serum CPR，IL-6 and TNF-α between the two groups before operation （P>0.05）.The levels of serum CPR，IL-6 and TNF-α after operation were significantly higher than those before operation in the two groups （P<0.05）.The levels of serum CPR，IL-6 and TNF-α in the observation group were significantly lower than those in the control group after operation （P<0.05）.There was no significant difference in the levels of CD4+，CD8+，CD4+/CD8+ and NK cells between the two groups before operation （P>0.05）.Compared with before operation，the levels of CD4+，CD4+/CD8+ and NK cells in peripheral blood were significantly lower，and the level of CD8+ was significantly higher after operation in the two groups （P<0.05）.The levels of CD4+，CD4+/CD8+ and NK cells in peripheral blood of patients in the observation group were significantly higher than those in the control group，and the level of CD8+ was significantly lower than that in the control group after operation（P<0.05）.Conclusion　Compared with open radical resection of colon cancer，the laparoscopic radical resection of colon cancer has the advantages of less trauma，less bleeding，less inflammation reaction，faster postoperative recovery and less impact on patients′ immune function.

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更新日期/Last Update: 2019-05-05