腹腔镜结直肠癌根治术对机体免疫状态的影响

摘要
图/表
参考文献(15)
相关文章 (15)

全文: PDF (0 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS) 背景资料

文章导读

摘要目的探讨腹腔镜结直肠癌根治术对机体免疫状态的影响。方法选取2018年1月～2019年12月大连市第五人民医院收治的80例结直肠癌患者作为研究对象，根据随机数字表法将其分为对照组与研究组，每组各40例。对照组患者采用开腹手术，研究组患者采用腹腔镜结直肠癌根治术。比较两组患者术前及术后7 d 的T淋巴细胞亚群水平、血清免疫球蛋白水平以及炎症因子水平。结果术前，研究组患者的CD3[（57.55±4.13）%]、CD4[（32.81±3.52）%]、CD8[（27.51±3.24）%]及CD4/CD8（1.11±0.25）水平与对照组[（57.52±4.24）%、（32.74±3.55）%、（27.55±3.41）%、1.12±0.12]比较，差异无统计学意义（P>0.05）；术后7 d，研究组患者的CD3[（56.85±4.08）%]、CD4[（31.02±4.10）%]、CD8[（27.05±3.14）%]及CD4/CD8（1.10±0.15）水平与对照组患者的CD3[（50.58±3.79）%]、CD4[（28.05±4.21）%]、CD8[（25.79±4.12）%]及CD4/CD8（1.01±0.22）水平均低于术前，差异有统计学意义（P<0.05）；术后7 d，研究组患者的CD3、CD4、CD8 及CD4/CD8 水平均高于对照组，差异有统计学意义（P<0.05）。术前，研究组患者的免疫球蛋白G（IgG）[（28.61±2.75）U/mL]、免疫球蛋白A（IgA）[（157.24±21.58）U/mL]及免疫球蛋白M（IgM）[（171.05±21.87）U/mL]水平与对照组[（28.58±2.68）、（157.68±20.65）、（170.98±25.41）U/mL]比较，差异无统计学意义（P>0.05）；术后7 d，研究组患者的IgG[（27.25±2.44）U/mL]、IgA[（145.78±19.68）U/mL]及IgM[（168.97±17.85）U/mL]水平与对照组患者的IgG[（26.45±3.21）U/mL]、IgA[（142.87±22.54）U/mL]及IgM[（164.21±16.85）U/mL]水平均低于术前，差异有统计学意义（P<0.05）；术后7 d，研究组患者的IgG、IgA 及IgM 水平均高于对照组，差异有统计学意义（P<0.05）。术前研究组患者的白介素-6（IL-6）[（17.92±4.68）ng/L]、C-反应蛋白（CRP）[（5.18±1.22）mg/L]及肿瘤坏死因子-α（TNF-α）[（33.64±6.78）ng/mL]水平与对照组[（17.85±5.32）ng/L、（5.12±1.51）mg/L、（33.58±8.15）ng/mL]比较，差异无统计学意义（P>0.05）；术后7 d，研究组患者的IL-6[（32.89±5.25）ng/L]、CRP[（18.65±4.78）mg/L]及TNF-α [（44.27±5.62）ng/mL]水平与对照组患者的IL-6 [（55.87±7.25）ng/L]、CRP [（38.65±8.95）mg/L]及TNF-α[（50.58±10.52）ng/mL]水平均高于术前，差异有统计学意义（P<0.05）；术后7 d，研究组患者的IL-6、CRP 及TNF-α水平均低于对照组，差异有统计学意义（P<0.05）。结论腹腔镜结直肠癌根治术能够降低对机体免疫状态造成的影响，值得临床推广应用。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	吕永柱王大巍▲ 徐才任飞

关键词 ： , font-size: 16px, text-align: justify, 腹腔镜')" href="#">">腹腔镜, 开腹手术, 结直肠癌, 机体免疫状态, 腹腔镜结直肠癌根治术

Abstract： Objective To investigate the effect of laparoscopic radical treatment of colorectal cancer on the immune status of the body.Methods A total of 80 patients with colorectal cancer who admitted to the Fifth People′s Hospital of Dalian City from January 2018 to December 2019 were selected as the study objects and divided into the control group and the study group according to the random number table method,with 40 patients in each group.The control group was treated with open surgery,while the study group was treated with laparoscopic radical resection of colorectal cancer.The T-lymphocyte subsets,serum immunoglobulin levels and inflammatory factors were compared between the two groups before and after 7 d of surgery.Results There were no statistically significant differences in the levels of CD3,CD4,CD8,CD4/CD8 before surgery between the study group ([57.55±4.13]%,[32.81±3.52]%,[27.51±3.24]%,1.11±0.25)and the control group ([57.52±4.24]%,[32.74±3.55]%,[27.55±3.41]%,1.12±0.12) (P>0.05).After 7 d of surgery,the levels of CD3,CD4,CD8,CD4/CD8 in the study group ([56.85±4.08]%,[31.02±4.10]%,[27.05±3.14]%,1.10±0.15) and the levels of CD3,CD4,CD8,CD4/CD8 in the control group ([50.58±3.79]%,[28.05±4.21]%,[25.79±4.12]%,1.01±0.22)were lower than those before surgery,and the differences were statistically significant (P<0.05).After 7 d of surgery,the levels of CD3,CD4,CD8,CD4/CD8 in the study group were higher than those in the control group,and the differences were statistically significant (P<0.05).There were no statistically significant differences in the levels of immunoglobulin G (IgG),immunoglobulin A (IgA) and immunoglobulin M (IgM) before surgery between the study group ([28.61±2.75],[157.24±21.58],[171.05±21.87]U/mL) and the control group ([28.58±2.68],[157.68±20.65],[170.98±25.41]U/mL) (P>0.05).After 7 d of surgery,the levels of IgG,IgA and IgM in the study group ([27.25±2.44],[145.78±19.68],[168.97±17.85]U/mL) and the levels of IgG,IgA and IgM in the control group ([26.45±3.21],[142.87±22.54],[164.21±16.85]U/mL) were lower than those before surgery,and the differences were statistically significant (P<0.05).After 7 d of surgery,the levels of IgG,IgA and IgM in the study group were higher than those in the control group,and the differences were statistically significant (P<0.05).There were no statistically significant differences in the levels of interleukin-6 (IL-6),C-reactive protein (CRP) and tumer necrosis factor-α (TNF-α) before surgery between the study group ([17.92±4.68]ng/L,[5.18±1.22]mg/L],[33.64±6.78]ng/mL) and the control group ([17.85±5.32]ng/L,[5.12±1.51]mg/L,[33.58±8.15]ng/mL) (P>0.05).After 7 d of surgery,the levels of IL-6,CRP and TNF-α in the study group([32.89±5.25]ng/L,[18.65±4.78]mg/L,[44.27±5.62]ng/mL) and the levels of IL-6,CRP and TNF-α in the control group ([55.87±7.25]ng/L,[38.65±8.95]mg/L,[50.58±10.52]ng/mL) were higher than those before surgery,and the differences were statistically significant (P<0.05).After 7 d of surgery,the levels of IL-6,CRP and TNF-α in the study group were lower than those in the control group,and the differences were statistically significant (P<0.05).Conclusion Laparoscopic radical treatment of colorectal cancer can reduce the impact on the immune status of the body,and it is worthy of clinical promotion and application.

Key words： font-size: 16px Laparoscopic;Open surgery;Colorectal cancer;Immune status of the body;Laparoscopic radical treatment of colorectal cancer')" href="#">text-align: justify;">Laparoscopic;Open surgery;Colorectal cancer;Immune status of the body;Laparoscopic radical treatment of colorectal cancer

PACS:

基金资助:

引用本文:

吕永柱王大巍▲ 徐才任飞. 腹腔镜结直肠癌根治术对机体免疫状态的影响[J]. 中国当代医药, 2020, 27(32): 70-72.
LYU Yong-zhu WANG Da-wei▲ XU Cai REN Fei. Effect of laparoscopic radical treatment of colorectal cancer on the immune status of the body. 中国当代医药, 2020, 27(32): 70-72.

链接本文:

https://www.dangdaiyiyao.com/CN/ 或 https://www.dangdaiyiyao.com/CN/Y2020/V27/I32/70

[1]	刘彤，李楠，翟超，等.中转开腹时机对腹腔镜结直肠癌根治术预后的影响[J].中华消化外科杂志，2019，18（5）：484-488.
[2]	郭鹏，张治清，兰远志，等.腹腔镜结直肠癌根治术联合肝转移灶射频消融术与开腹结直肠癌肝转移根治术的疗效分析[J].中华消化外科杂志，2018，17（5）：459-465.
[3]	Oh TK，Yim J，Kim J，et al.Effects of preoperative ultrasoundguided transversus abdominis plane block on pain after laparoscopic surgery for colorectal cancer：a double-blind randomized controlled trial[J].Surg Endosc，2017，31（1）：127-134.
[4]	朱广伟，郑炜，黄永建，等.腹腔镜下右半结肠癌根治术“头侧-中央混合入路方式”近期疗效评价[J].肿瘤防治研究，2017，44（12）：827-830.
[5]	李国新，李俊蒙，王亚楠，等.单孔和减孔腹腔镜结直肠癌切除术发展现状及展望[J].中华外科杂志，2017，55（7）：486-490.
[6]	骆洋，陈建军，秦骏，等.腹腔镜直肠癌根治术中肠系膜下动脉低位结扎对第3 站淋巴结清扫的影响及第3 站淋巴结转移危险因素分析[J].中华消化外科杂志，2018，17（2）：154-160.
[7]	Klaver CEL，Stam R，Sloothaak DAM，et al.Colorectal cancer at high risk of peritoneal metastases：long term outcomes of a pilot study on adjuvant laparoscopic HIPEC and future perspectives[J].Oncotarget，2017，8（31）：51 200-51 209.
[8]	张广坛，宋玉成，张学东.T4 局部进展期结直肠癌患者腹腔镜下根治性多器官切除术的疗效[J].中华普通外科杂志，2017，32（7）：627-628.
[9]	曾焕虹，傅卫，孙涛，等.腹腔镜直肠癌根治术后患者的长期生存及其影响因素[J].中华普通外科杂志，2018，33（1）：25-29.
[10]	Liu JQ，Yang SJ，Chen JQ，et al.Effect on changes of blood coagulation function，cytokines and immune function in patients undergoing laparoscopic radical gastrectomy for gastric cancer[J].J Hainan Med Univ，2017，23（1）：104-108.
[11]	佟伟华，何亮，张路遥，等.腹腔镜辅助经肛全直肠系膜切除术治疗低位直肠癌患者术后排便功能评价及其影响因素分析[J].中华消化外科杂志，2019，18（8）：761-767.
[12]	Ilic D，Evans SM，Allan CA，et al.Laparoscopic and robotassisted vs.open radical prostatectomy for the treatment of localized prostate cancer：a Cochrane systematic review[J].BJU Int，2018，121（6）：845-853.
[13]	王亮，田洁，许跃军，等.后腹腔镜根治术对肾癌患者免疫功能的影响[J].现代生物医学进展，2017，17（11）：2110-2112.
[14]	汤雪峰，李财宝，刘岗，等.腹腔镜微创手术与传统开腹手术对结直肠癌患者免疫和生理功能影响的临床观察[J].标记免疫分析与临床，2015，22（4）：278-575.
[15]	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，2006，45（8）：615-618.