腔镜联合手术对老年食管癌术后细胞免疫功能的影响

目的研究胸、腹腔镜联合术对老年食管癌患者术后细胞免疫功能的影响。方法将64例老年食管癌患者按照接受手术方式的不同分为胸、腹腔镜联合术组(观察组)和传统手术组(对照组),分析2组患者手术相关指标及其对细胞免疫功能的影响。结果观察组手术时间、切口总长度、术中出血量、术后疼痛评分和住院天数均显著低于对照组。观察组术后7 d的CD4+和CD4+/CD8+水平均较术前显著降低;对照组术后7 d的CD4+、CD8+、CD4+/CD8+和自然杀伤细胞(NK细胞)水平均较术前显著降低,但观察组术后7 d的CD8+、CD4+/CD8+和NK细胞水平显著低于对照组。结论胸、腹腔镜联合术在治疗老年食管癌方面具有明显的微创优势,术后恢复快,且对细胞免疫功能影响小。

Effects of the combined thoracic-laparoscopic surgery on the postoperative cellular immune function of senile esophageal cancer

Objective To study the effects of the combined thoracicA1.laparoscopic surgery on the postoperative cellular immune function of senile patients with esophageal cancer.Methods According to different operation procedures,64 senile patients with esophageal cancer were divided into the combined thoracicA1.laparoscopic surgery group(observation group) and traditional surgery group(control group).The operationA1.related indexes and effects of operation on the cellular immune function in patients of the two groups were analyzed.Results The operation time,total incision length,bleeding during operation,postoperative pain score and hospital stay in observation group were all significantly lower than those in the control group.The levels of CD4+ and CD4+/CD8+ 7 days after operation in observation group notably decreased compared with before treatment.The levels of CD4+,CD8+,CD4+/CD8+ and natural killer cells(NK cells) 7 days after operation in the control group conspicuously decreased compared with before treatment,whereas the levels of CD8+,CD4+/CD8+ and NK cells 7 days after operation in the observation group were markedly lower than those in the control group.The difference was statistically significant.Conclusion The combined thoracicA1.laparoscopic surgery in the treatment of senile esophageal cancer has distinct minimally invasive advantages,rapid recovery and less impact on the cellular immune function.