腹腔镜辅助远端胃癌根治术的临床疗效及对患者免疫功能的影响

目的 探讨腹腔镜辅助远端胃癌根治术的临床疗效及对患者免疫功能的影响.方法 将60例胃癌患者按照接受手术时间顺序分为观察组和对照组,每组30例.对照组采用传统开腹远端胃癌根治术,观察组采用腹腔镜辅助远端胃癌根治术.比较2组的手术情况、术后并发症及免疫功能.结果 观察组的术中出血量、术后进流质时间、排便时间、总住院时间及住院费用均显著低于对照组(P<0.05),清扫淋巴结数目显著高于对照组(P<0.05);观察组术后并发症发生率(13.33%)显著低于对照组(30.00%)(P<0.05).手术后7天,2组的hs-CRP、IL-6、IL-10水平均较手术前显著升高(P<0.05),但观察组的hs-CRP、IL-6水平显著低于对照组(P<0.05),IL-10水平显著高于对照组(P<0.05).CD4+和CD4+/CD8+水平较手术前显著升高(P<0.05),CD8+较手术前显著降低(P<0.05);且观察组的CD4+和CD4+/CD8+水平显著高于对照组(P<0.05),CD8+水平显著低于对照组(P<0.05).结论 与传统开腹手术相比,腹腔镜辅助远端胃癌根治术的临床效果显著,可促进患者恢复,降低并发症发生率,降低免疫应激反应,减少对免疫功能的损伤.

Clinical Effect and Influence on the Immune Function of Laparoscopic-assisted Gastrectomy for Distantgastric Cancer

Objective To investigate the clinical effect and influence on the immune function of laparoscopic-assisted gastrectomy for distant gastric cancer. Methods 60 cases of patients with stomach cancer were divided into the observation group and the control group,30 cases in each group,patients in the control group were treated with traditional laparotomyradical correc-tion for stomach cancer,and patients in the observation group were treated with laparoscopic-assisted radical correction for stomach cancer. The clinical effect,postoperative complication and immune function were compared between the 2 groups. Results The intraoperative blood loss,eating flow time after surgery,defecating time,total length of hospital stay,hospitalized expense and com-plication incidence rate of the observation group were significantly lower than those of the control group(P<0. 05),and the scan-ning number of lymph nodes were significantly higher than that of the control group(P<0. 05);7 days after surgery,levels of hs-CRP、IL-6、IL-10 in the 2 groups were significantly higher than before surgery(P<0. 05),and levels of hs-CRP、IL-6 in the ob-servation group were significantly lower than that of the control group(P<0. 05),IL-10 level was significantly higher than that of the control group(P<0. 05);after surgery,levels of CD4 + and CD4 + /CD8 + in the 2 groups were significantly higher than before (P<0. 05),and CD8 + was significantly lower than before (P<0. 05);levels of CD4 +and CD4 + /CD8 + in the observation group were significantly higher than those of the control group(P<0. 05),CD8 + was significantly lower than that of the control group(P<0. 05). Conclusion Compared with traditional laparotomy radical correction for stomach cancer,laparoscopic-assisted radical correction for stomach cancer has remarkable clinical effect,it can promote recovery,reduce the complication incidence rate and immunological stress reaction,reduce the damage of immune function.