引用本文:朱 州,黄顺荣,秦 俭,钟晓刚,王晓通.腹腔镜手术与开腹手术治疗老年右半结肠癌的疗效及对术后炎症状态和免疫功能影响的对比观察[J].中国临床新医学,2019,12(9):960-963.
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腹腔镜手术与开腹手术治疗老年右半结肠癌的疗效及对术后炎症状态和免疫功能影响的对比观察
朱 州,黄顺荣,秦 俭,钟晓刚,王晓通
530021 南宁,广西壮族自治区人民医院胃肠外科
摘要:
[摘要] 目的 对比观察腹腔镜手术和开腹手术治疗老年右半结肠癌的疗效以及对患者术后炎症状态和免疫功能的影响。方法 回顾性分析2017-01~2018-06该院收治的75例老年右半结肠癌患者,根据术式不同分为开腹手术组和腹腔镜手术组,其中腹腔镜手术组36例,开腹手术组39例。比较两组患者手术效果、术后炎症状态和T细胞亚群的变化。结果 腹腔镜手术组手术时间、手术切口长度以及术中出血量均明显低于开腹手术组,差异有统计学意义(P<0.05)。腹腔镜手术组血清C反应蛋白(CRP)、白介素-6(IL-6)水平低于开腹手术组,差异有统计学意义(P<0.05)。术后1 d,两组患者CD3+、CD4+及CD4+/CD8+水平均明显下降,且腹腔镜手术组下降幅度明显低于开腹手术组,术后CD8+水平明显升高,且腹腔镜手术组升高幅度明显低于开腹手术组,差异有统计学意义(P<0.05)。结论 腹腔镜手术治疗右半结肠癌近期疗效更好、患者术后炎症反应轻、对免疫功能影响较小,值得临床推广应用。
关键词:  腹腔镜  结肠癌  开腹手术  炎症反应  免疫功能
DOI:10.3969/j.issn.1674-3806.2019.09.07
分类号:R 735.3
基金项目:国家自然科学基金资助项目(编号:81860443);广西自然科学基金项目(编号:2016GXNSFAA380106)
Curative effects of minimally invasive laparoscopy and laparotomy on treatment of right hemicolon carcinoma in elderly patients and their effects on postoperative inflammatory status and immune function
ZHU Zhou, HUANG Shun-rong, QIN Jian, et al.
Department of Gastrointestinal Surgery, the People′s Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, China
Abstract:
[Abstract] Objective To compare the curative effects of minimally invasive laparoscopy and laparotomy on treatment of right hemicolon carcinoma in elderly patients and the effects of the two operation methods on postoperative inflammatory status and immune function. Methods The clinical data of 75 patients with right hemicolon carcinoma who were admitted to our hospital from January 2017 to June 2018 were analyzed retrospectively. According to different operation methods, the patients enrolled were assigned to laparoscopy group(n=36) and laparotomy group(n=39). The surgical effects, postoperative inflammatory status and the changes of T cell subsets were compared between the two groups. Results The operation time and the length of incision in the laparoscopy group were significantly shorter than those in the laparotomy group(P<0.05), and the amount of blood loss in the laparoscopy group was significantly less than that in the laparotomy group(P<0.05). The levels of serum C-reaction protein(CRP) and interleukin-6(IL-6) in the laparoscopy group were significantly lower than those in the laparotomy group(P<0.05). Compared with those before operation, the levels of CD3+, CD4+ and CD4+/CD8+ were significantly decreased in both of the two groups one day after operation, but the decreasing degrees of them in the laparoscopy group were significantly less than those in the laparotomy group(P<0.05). Compared with those before operation, the levels of CD8+ were significantly increased in both of the two groups one day after operation, but the increasing degrees of them in the laparoscopy group were significantly less than those in the laparotomy group(P<0.05). Conclusion Laparoscopic surgery has a better short-term efficacy in treatment of right hemicolon carcinoma and has a mild postoperative inflammatory response to the patients and low impact on the immune function, which is worthy of clinical application.
Key words:  Laparoscopy  Colon cancer  Laparotomy  Inflammatory response  Immune function