腹腔镜胃癌根治术对机体免疫功能及腹腔微转移的影响
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摘要
目的探讨腹腔镜胃癌根治术对机体免疫功能及腹腔微转移的影响。方法以入院病例号为编号,根据随机数字表,将120例胃癌患者进行随机分组为实验组和对照组各60例。实验组患者实施腹腔镜根治术治疗,对照组患者实施传统开腹胃癌根治术,观察比较两组患者手术指标、应激炎性指标、免疫指标和微转移指标差异。结果实验组患者出血量(179. 94±31. 46) ml、切口长度(5. 12±2. 78) cm、肠功能恢复时间(54. 97±10. 36) h,治疗后CRP(13. 96±3. 45)μg/l、IL-6(57. 49±6. 01)μg/l、IL-10(231. 74±21. 94) pg/ml,CD4(11. 63±1. 21)%、CD8(3. 41±0. 73)%、CD4+/CD8+(3. 56±0. 19),DDC(125. 82±18. 02) ng/ml、CEA(151. 07±251. 94) ng/ml,与对照组比较存在明显差异,差异具有统计学意义(P <0. 05)。结论腹腔镜手术治疗胃癌患者的近期临床疗效较好,对患者造成的机体创伤较小及对免疫功能的影响较小,同时患者术后发生微转移的风险较小,具有一定临床应用价值,且为腹腔镜手术在胃癌患者治疗中的广泛应用提供了有效依据。
Objective To investigate the effect of laparoscopic radical gastrectomy on immune function and peritoneal micrometastasis. Methods According to the number of hospitalized cases and the random number table,120 patients with gastric cancer were randomly divided into experimental group and control group,60 cases each. The patients in the experimental group were treated with laparoscopic radical mastectomy. The patients in the control group were treated by conventional open radical gastrectomy. The differences of surgical indexes,inflammatory inflammatory indexes,immune indexes and micrometastasis indexes were observed and compared between the two groups. Results The bleeding volume in the experimental group was( 179. 94 ±31. 46) ml,the incision length was( 5. 12 ± 2. 78) cm,the recovery time of intestinal function was( 54. 97 ± 10. 36) h,and the CRP was( 13. 96 ± 3. 45) μg/l and IL-6( 57. 49 ± 6. 01),IL-10( 231. 74 ± 21. 94) pg/ml,CD4( 11. 63 ± 1. 21) %,CD8( 3. 41± 0. 73) %,CD4+/CD8+( 3. 56 ± 0. 19),DDC( 125. 82 ± 18. 02) ng/ml and CEA( 151. 07 ± 251. 94) ng/ml,compared with the control group,the difference was statistically significant( P < 0. 05). Conclusion Laparoscopic surgery for the treatment of gastric cancer in patients with recent clinical efficacy is good,the patient caused less trauma and less impact on immune function,and patients with less risk of postoperative micrometastasis,has some clinical value and is the abdominal cavity Mirror surgery in the treatment of patients with gastric cancer provides a valid basis.
Objective To investigate the effect of laparoscopic radical gastrectomy on immune function and peritoneal micrometastasis. Methods According to the number of hospitalized cases and the random number table,120 patients with gastric cancer were randomly divided into experimental group and control group,60 cases each. The patients in the experimental group were treated with laparoscopic radical mastectomy. The patients in the control group were treated by conventional open radical gastrectomy. The differences of surgical indexes,inflammatory inflammatory indexes,immune indexes and micrometastasis indexes were observed and compared between the two groups. Results The bleeding volume in the experimental group was( 179. 94 ±31. 46) ml,the incision length was( 5. 12 ± 2. 78) cm,the recovery time of intestinal function was( 54. 97 ± 10. 36) h,and the CRP was( 13. 96 ± 3. 45) μg/l and IL-6( 57. 49 ± 6. 01),IL-10( 231. 74 ± 21. 94) pg/ml,CD4( 11. 63 ± 1. 21) %,CD8( 3. 41± 0. 73) %,CD4+/CD8+( 3. 56 ± 0. 19),DDC( 125. 82 ± 18. 02) ng/ml and CEA( 151. 07 ± 251. 94) ng/ml,compared with the control group,the difference was statistically significant( P < 0. 05). Conclusion Laparoscopic surgery for the treatment of gastric cancer in patients with recent clinical efficacy is good,the patient caused less trauma and less impact on immune function,and patients with less risk of postoperative micrometastasis,has some clinical value and is the abdominal cavity Mirror surgery in the treatment of patients with gastric cancer provides a valid basis.
引文
[1] He GL,Jiang ZS,Cheng Y,et al. Tripartite comparison of single-incision and conventional laparoscopy in cholecystectomy:A multicenter trial〔J〕. World J Gastrointest Endos2015,7(4):540-546.
[2]范亚男.腹腔镜手术与开腹手术对进展期远端胃癌患者肿瘤根治效果和术后生存质量影响的对比研究〔J〕.中国医学前沿杂志,2017,9(1):126-130.
[3]倪宏,李长江,项系青.腹腔镜胆囊切除术对机体炎症反应、氧化应激及细胞免疫功能的影响〔J〕.海南医学院学报,2016,22(2):160-162.
[4] Yi lmazlar F,Karabayi rli S,Go zdemir M,et al. The effect of positive end-expiratory pressure on inflammatory cytokines during laparoscopic cholecystectomy〔J〕. Saudi Med J,2015,36(11):1358-1362.
[5]余伯成.腹腔镜胃癌D2根治术和开腹胃癌D2根治术中患者炎症反应比较〔J〕.临床与病理杂志,2015,35(7):1298-1303.
[6]王岩.胃癌D2根治术不同术式对胃癌患者血清细胞因子的影响〔J〕.中国现代医生,2015,53(10):13-15.
[7]杨士英,赵亚刚. Hp-L型,Livin与胃癌关系的研究进展〔J〕.实用医学杂志,2012,28(13):2280-2282.
[8]程康文,王贵和,束宽山,等.腹腔镜辅助与开腹胃癌根治术临床效果及对肠道屏障功能影响的比较〔J〕.中国普通外科杂志,2017,26(4):450-456.
[9]黄灵,杜义安,俞鹏飞.腹腔镜胃癌根治术与开腹胃癌根治术对机体炎性反应和免疫功能的影响〔J〕.中国现代医生,2015,53(17):25-28.
[10] Silvaroli S,Montalembert M,Sauvat F,et al. Laparoscopic Splenectomy in Children:A Modified Technique with Joint Sealing of Segmental Splenic Arteries and Veins Favorably Compared with the Classic Technique〔J〕. Eur J Pedia tr Surg,2017,27(1):91-95.
[11]韦斌,黄俏莹,钟晓刚,等.腹腔镜与开腹手术对进展期胃癌患者围术期手术疗效及对免疫功能的影响〔J〕.中国老年学杂志,2015,35(9):2437-2439.
[12]张英杰,梁金荣.腹腔镜胃癌根治术治疗进展期胃癌患者的近期疗效及对腹腔内微转移的影响〔J〕.中华全科医学,2017,15(11):1867-1869.
[13]王红岩,赵晓丹,李国胜,等.腹腔镜辅助与开腹胃癌D2根治术治疗局部进展期远端胃癌的安全性及近期疗效Meta分析〔J〕.中国医科大学学报,2015,44(3):252-258.
[14]张治国,薛慧婧,宋仕茂,等.腹腔镜根治术治疗胃癌的效果观察及其免疫功能和应激炎性因子的变化情况分析〔J〕.胃肠病学和肝病学杂志,2015,24(6):724-727.
[15] Morales-Conde S,Caete-Gómez J,Gómez V,et al. Laparoendoscopic Single-Site Cholecystectomy:First Experiences with a New Standardized Technique Replicating the FourPort Technique〔J〕. J Laparoendosc Adv Surg Tech A,2016,26(10):812-815.
[2]范亚男.腹腔镜手术与开腹手术对进展期远端胃癌患者肿瘤根治效果和术后生存质量影响的对比研究〔J〕.中国医学前沿杂志,2017,9(1):126-130.
[3]倪宏,李长江,项系青.腹腔镜胆囊切除术对机体炎症反应、氧化应激及细胞免疫功能的影响〔J〕.海南医学院学报,2016,22(2):160-162.
[4] Yi lmazlar F,Karabayi rli S,Go zdemir M,et al. The effect of positive end-expiratory pressure on inflammatory cytokines during laparoscopic cholecystectomy〔J〕. Saudi Med J,2015,36(11):1358-1362.
[5]余伯成.腹腔镜胃癌D2根治术和开腹胃癌D2根治术中患者炎症反应比较〔J〕.临床与病理杂志,2015,35(7):1298-1303.
[6]王岩.胃癌D2根治术不同术式对胃癌患者血清细胞因子的影响〔J〕.中国现代医生,2015,53(10):13-15.
[7]杨士英,赵亚刚. Hp-L型,Livin与胃癌关系的研究进展〔J〕.实用医学杂志,2012,28(13):2280-2282.
[8]程康文,王贵和,束宽山,等.腹腔镜辅助与开腹胃癌根治术临床效果及对肠道屏障功能影响的比较〔J〕.中国普通外科杂志,2017,26(4):450-456.
[9]黄灵,杜义安,俞鹏飞.腹腔镜胃癌根治术与开腹胃癌根治术对机体炎性反应和免疫功能的影响〔J〕.中国现代医生,2015,53(17):25-28.
[10] Silvaroli S,Montalembert M,Sauvat F,et al. Laparoscopic Splenectomy in Children:A Modified Technique with Joint Sealing of Segmental Splenic Arteries and Veins Favorably Compared with the Classic Technique〔J〕. Eur J Pedia tr Surg,2017,27(1):91-95.
[11]韦斌,黄俏莹,钟晓刚,等.腹腔镜与开腹手术对进展期胃癌患者围术期手术疗效及对免疫功能的影响〔J〕.中国老年学杂志,2015,35(9):2437-2439.
[12]张英杰,梁金荣.腹腔镜胃癌根治术治疗进展期胃癌患者的近期疗效及对腹腔内微转移的影响〔J〕.中华全科医学,2017,15(11):1867-1869.
[13]王红岩,赵晓丹,李国胜,等.腹腔镜辅助与开腹胃癌D2根治术治疗局部进展期远端胃癌的安全性及近期疗效Meta分析〔J〕.中国医科大学学报,2015,44(3):252-258.
[14]张治国,薛慧婧,宋仕茂,等.腹腔镜根治术治疗胃癌的效果观察及其免疫功能和应激炎性因子的变化情况分析〔J〕.胃肠病学和肝病学杂志,2015,24(6):724-727.
[15] Morales-Conde S,Caete-Gómez J,Gómez V,et al. Laparoendoscopic Single-Site Cholecystectomy:First Experiences with a New Standardized Technique Replicating the FourPort Technique〔J〕. J Laparoendosc Adv Surg Tech A,2016,26(10):812-815.