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腹腔镜辅助与开腹结肠癌根治术免疫及安全性分析比较
作者:樊向文 席量 
单位:内蒙古包钢医院肿瘤外科 内蒙古 包头 014010 
关键词:腹腔镜 结肠肿瘤 淋巴结清扫 
分类号:R 7353
出版年,卷(期):页码:2018,35(1):1-3
摘要:

 摘要:目的探讨腹腔镜与开腹结直肠癌根治术免疫功能及安全性。 方法回顾性分析我院2014年1月至2017年1月本院诊治的80例均经病理证实为结肠癌的患者为研究对象,包括腹腔镜手术40例和开腹手术40例,观察免疫功能、安全性与开腹组进行比较。结果结肠标本肿块距近切缘的长度、远切缘的长度,直肠标本肿块距近切缘、远切缘长度和淋巴结清扫数目及阳性数,差异无统计学意义(均P>005)。IL\|2较术前明显降低,开腹组术后较腹腔镜组降低更明显,两组间比较差异有统计学意义(P<001);TNF\|α及IL\|6均明显高于术前,IL\|6两组间比较差异有统计学意义(P<005);但术后第7 d时TNF\|α恢复到术前水平;FIN\|γ、IL\|10两组均有所下降,开腹组下降较腹腔镜组明显,两组间比较差异有统计学意义(P<005)。两组患者的CD4+水平与 CD8+水平均出现显著性降低,两组间比较差异有统计学意义(P<005);在手术后第7 d,与腹腔镜组相比开腹组的 CD8+水平与CD4+水平降低更加显著,而NK细胞活性两组变化不明显,开腹组术后3 d降低,而腹腔镜组术后7 d降低。结论与传统开腹手术比较,腹腔镜结直肠癌手术对患者细胞免疫功能指标及应激反应指标的影响小,更有利于患者的术后恢复,值得临床推广应用。关键词:腹腔镜;结肠肿瘤;淋巴结清扫

 Abstract:ObjectiveTo investigate the immune function and safety of laparoscopic and open radical resection of colorectal cancer MethodsRetrospective analysis of 80 cases were confirmed advanced colorectal cancer by pathology in our hospital from January 2014 to March 2017 as the research object,including 40 cases of laparoscopic surgery and 40 cases of open radical resection,immune function and safety were compared ResultsThere were no significant differences in the length of the distance from the margin of the colon specimen,the length of the distal margin,the distance from the margin of the rectal specimen,the length of the distal margin and the number of lymph nodes and the positive number(P>005) IL\|2 was significantly lower than that in laparoscopic group(P<001) TNF\|α and IL\|6 were significantly higher than those in laparoscopic group,there were significant differences between the two groups(P<005) FIN\|γ and IL\|10 decreased,while the difference between the two groups was significantly higher than that in the laparoscopic group The difference was statistically significant(P<005) On the 7th day after operation,TNF\|α returned to the preoperative level;FIN\|γand IL\|10 decreased in two groups,and in the laparotomy group more significantly than the laparoscopic group,the difference was statistically significant(P<005) The levels of CD4+ and CD8+ decreased significant in two groups,the difference was statistically significant(P<005);On the 7th day after operation,compared with the laparoscopic group,the levels of CD4+ and CD8+ in the control group were decreased more significantly(P<005),and NK cell activity in two groups of patients did not change significantly,decreased on the third day in radical resection group,and on the 7th days in laparotomy group ConclusionCompared with traditional open radical resection,laparoscopic radical resection of colorectal cancer has less influence on immune index and stress response index,more benefit for postoperative recovery and be worthy of promotingKey Words:Laparoscopy;Colon tumors;Lymph node dissection

基金项目:
作者简介:
参考文献:

 参考文献\[1\]赵保玉,李国新,王亚楠,等.腹腔镜与开腹结直肠癌根治术对腹膜结构损伤的前瞻性对照研究\[J\].中华胃肠外科杂志,2010,13(3):193\|196.

[2]谢方利,韩伟,陈志刚,等.腹腔镜结直肠癌手术与传统根治术临床对比研究\[J\].结直肠肛门外科,2010,16(4):223\|226.
\[3\]曹其彬,胡三元.腹腔镜与开腹结直肠癌手术对机体免疫功能的比较\[J\].中国普通外科杂志,2006,15(8):615\|618.
[4]吴卫,唐卫中,龙陈艳,等.结直肠癌腹腔镜围手术期机体免疫生理变化研究\[J\].结直肠肛门外科,2011,17(1):11\|14.
[5]彭超.腹腔镜胃癌根治术对患者免疫功能的影响\[J\].医学综述,2013,19(6):1026\|1028.
[6]周桥灵,梁桦,刘洪珍,等.不同全麻下腹腔镜结肠癌切除术病人围术期细胞免疫功能的比较\[J\].中华麻醉学杂志,2011,31(8):909\|912.
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