临床普外科电子杂志 ›› 2023, Vol. 11 ›› Issue (4): 6-.

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腹腔镜结直肠癌根治术对结直肠癌患者围手术期免疫功能和血清炎症因子的影响

  

  1. 玉林市容县中西医结合骨科医院 外二科,广西 容县 537500
  • 出版日期:2023-10-01 发布日期:2023-12-20

The effect of laparoscopic radical resection of colorectal cancer on perioperative immune function and serum inflammatory factors in patients with colorectal cancer

  1. Second Surgery Department of Rongxian Integrated Traditional Chinese and Western Medicine Orthopedic Hospital of Yulin City, Guangxi Rongxian 537500, China
  • Online:2023-10-01 Published:2023-12-20

摘要:

目的 探讨腹腔镜结直肠癌根治术对结直肠癌患者围手术期免疫功能、血清炎症因子的影响。方法 回顾性分析2020 年1 月至2023 年1 月玉林市容县中西医结合骨科医院80 例结直肠癌患者的临床资料,根据手术方式的不同分为开腹组和腹腔镜组。开腹组患者接受开腹结直肠手术治疗,共40 例,腹腔镜组患者采用腹腔镜结直肠癌根治术治疗,共40 例。对比两组患者的免疫功能[ 细胞免疫指标CD3+T 细胞、CD4+T 细胞、CD8+T 细胞、CD4+/CD8+,体液免疫指标免疫球蛋白(immunoglobulin,Ig)A、IgM、IgG]、血清炎症因子[ 肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白介素-6(interleukin-6,IL-6)、C 反应蛋白(C reactive protein,CRP)] 和并发症发生情况。结果 治疗后腹腔镜组患者的CD3+T 细胞、CD4+T细胞水平、CD4+/CD8+ 明显高于开腹组,CD8+T 细胞明显低于开腹组,差异均有显著性(P < 0.05)。治疗后,腹腔镜组患者的IgA、IgG 水平与开腹组无显著差异(P > 0.05),但IgM 水平高于开腹组,差异有显著性(P< 0.05)。治疗后,两组患者的TNF-α、IL-6、CRP 水平较治疗前均有明显上升,差异有显著性(P < 0.05)。腹腔镜组患者的并发症发生率显著低于开腹组(P < 0.05)。结论 腹腔镜结直肠癌根治术可减轻患者围手术期炎症应激反应,对患者免疫功能影响较小,并发症较少。

关键词: 腹腔镜结直肠癌根治术, 结直肠癌, 炎症因子, 影响

Abstract:

Objective To colorectal cancer patients for laparoscopic colorectal cancer radical, discuss the therapeutic effect and its influence on the immune function, serum inflammatory factors. Method Retrospective analysis the clinical data of 80 patients with colorectal cancer, according to the operation method of divided into open and laparoscopic group, open colorectal surgery treatment group received laparotomy, a total of 40 cases, treated by laparoscopic colorectal cancer radical laparoscopic group, a total of 40 cases. Compared to two groups of immune function in patients with [cellular immune index (CD3+, CD4+, CD8+ , CD4+/CD8+), humoral immune index (IgA, IgM and IgG)], serum inflammatory factors [serum tumor necrosis factor alpha (TNF alpha), interleukin 6

(IL-6), C reactive protein (CRP)] and complications. Result The laparoscopic group after treatment of CD3+, CD4+ group and CD4+/CD8+is significantly higher than laparotomy, CD8+, significantly lower than laparotomy group, the differences are significant (P < 0.05). After treatment, there was no significant difference in IgA and IgG levels between the laparoscopic group and the open group (P > 0.05), but IgM levels were higher than those in the open group, with a significant difference (P < 0.05). After treatment, the TNF-α of both groups of patients, the levels of IL-6 and CRP were significantly increased compared to before treatment, with significant differences (P < 0.05). The incidence of complications in the laparoscopic group was significantly lower than that in the open group (P < 0.05). Conclusion For patients with colorectal cancer can reduce inflammation in patients with laparoscopic colorectal cancer radical stress reaction, on the immune function of patients with smaller, less complications.

Key words: Laparoscopic colorectal cancer radical, Colorectal cancer, Serum levels of inflammatory cytokines, Effect