胸、腹腔镜食道癌手术对老年患者细胞免疫功能的影响

目的 分析胸、腹腔镜联合手术对老年食管癌患者手术后细胞免疫系统功能的影响.方法 回顾性分析2003年1月至2012年1月本院心胸外科收治的66例食管癌患者的临床资料,按治疗方式分成两组,传统手术组(T组,30例)予以传统开放手术,电视辅助胸腹腔镜手术组(Ⅴ组,36例)予以胸、腹腔镜联合手术,分析两组手术前后细胞免疫功能的变化. 结果 Ⅴ组手术时间、切口长度、术后疼痛分数、出血量、住院天数等均优于T组(P＜0.01);术前两组CD4+、CD8+、CD4 +/CD8+及NK细胞无显著差异,术后1周T组CD4+、CD4+/CD8+及NK细胞较术前显著下降(P＜0.01),且CD4+较Ⅴ组显著下降(P＜0.05),Ⅴ组仅CD4+较术前显著下降(P＜0.01). 结论 胸、腹腔镜联合手术较传统手术创伤更小,术中出血少,术后恢复快,对细胞免疫功能影响较小.

The Influence of Cell Immune Functions in the Elderly Esophageal Cancer Patients Underwent Thoracoscopic and Laparoscopic Surgery

Objective To analyze the function of the peri-operative cell immune system in elderly esophageal cancer patients underwent thoracoscopic and laparoscopic surgery.Methods The clinical data was retrospectively analyzed in 66 cases of elderly esophageal cancer patients.The patients were divided into two groups,conventional surgery group(T group) underwent the traditional open surgery,laparoscopic surgery with video-assisted thoracoscopy group(V group) underwent the combined endoscopic surgery.And the peri-operative cell immune functions were checked for all patients.Results Compared with the T group,the duration of the operation time,the length of the incision,the postoperative pain scores,the amount of bleeding and the hospitalization time were all less in the V group(P<0.01).And in the T group,CD4+,CD4+/CD8+ and NK cells significantly decreased 7 days after operation(P<0.01),and CD4+ was lower than that of the V group(P<0.05).While in the V group,only CD4+ decreased(P<0.01) and the other data was not changed significantly.Conclusion Compared with the traditional operation,the combined endoscopic operation is less trauma,less bleeding,more rapid recovery,and less impact on the peri-operative cell immune functions.