超声刀和电刀对胃癌患者手术前后免疫功能及应激的影响

目的 探讨超声刀和电刀对胃癌根治术后免疫功能和术后应激的影响.方法 前瞻性分析63例胃癌改良根治术患者资料,其中35例使用超声刀,28例用电刀,比较两组淋巴结清扫时间、术中出血量、术后72 h引流量情况,应用流式细胞仪测定两组术后外周血中T淋巴细胞亚群CD3+、CD4+、CD8+、CD4+/CD8+比率,术后第2天检测血白细胞计数、粒细胞百分比、C反应蛋白、血糖.结果 超声刀组与电刀组相比,CD3+、CD4+、CD8+、CD4+/CD8+比率,血糖无明显差异(P>0.05);对比术中出血量、淋巴结清扫时间、术后72 h引流量、白细胞计数、粒细胞百分比、C反应蛋白,超声刀组均有明显减少(P<0.05或P<0.01).结论 两种工具在胃癌根治术中切除效果及对术后免疫功能影响无明显差异,但应用超声刀术后恢复快且对术后应激反应小.

Effect of UAS versus electrotome in radical resection of gastric neoplasms on immunologic function and stress

Objective To compare the therapeutic effect of UAS vesus electrotome in the surgical treatment of gastric cancer on immunologic function and stress. Methods A prospective analysis was performed on 63 patients who received radical resection of gastric carcinoma. And 63 patients were randomly divided into two groups：35 cases subject to UAS;28 cases subject to electrotome. Operating time, blood loss volume, lymph node, drainage volume of 72 b after operation in the two groups were compared. CD3 ＋ , CIM ＋ , CD8 ＋ , CD4 ＋/CD8 ＋ ratio were analysed by FCM. White blood cell count, Neu, CRP, blood glucose also were tested two days after operation. Results There was no obvious difference in CD3 ＋ , CD4 ＋ , CD8 ＋ , CIM ＋ / CD8 ~ ratio,blood glucose between the two groups. However,the incidence of blood loss volume, operating time,lymph node, drainage volume of 72 h after operation, white blood cell count, Neu, CRP in group UAS was dramatically decreased as compared with group electrotome. Conclusions The therapeutic effect of UAS is better than that of electrotome in radical resection of gastric carcinoma.