临床普外科电子杂志 ›› 2025, Vol. 13 ›› Issue (3): 46-.

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单切口腹腔镜结肠癌根治术对老年结直肠癌患者术后免疫能力和应激反应的影响

  

  1. 1. 无锡市第二老年病医院 无锡市惠山区第二人民医院 普外科,江苏 无锡 214100;2. 江南大学附属医院 胃肠外科,江苏 无锡 214000
  • 出版日期:2025-07-01 发布日期:2025-11-20

The influence of single-incision laparoscopic radical resection of colon cancer on postoperative immune function and stress response in elderly patients with colorectal cancer

  1. 1. General Surgery Department of Wuxi Second Geriatric Hospital, Huishan District Second People's Hospital, Jiangsu Wuxi 214100, China; 2. Gastrointestinal Surgery Department of Affiliated Hospital of Jiangnan University,Jiangsu Wuxi 214000, China 
  • Online:2025-07-01 Published:2025-11-20

摘要:

目的 探讨单切口腹腔镜结肠癌根治术对老年结直肠癌患者术后免疫能力和应激反应的影响。方法 选择 2022 年 5 月至 2025 年 5 月无锡市第二老年病医院接受单切口腹腔镜治疗的结直肠癌患者 68 例,根据随机数字表法分为常规组和试验组,各 34 例。常规组接受常规开腹手术,试验组应用单切口腹腔镜结肠癌根治术。对比两组患者不同时间点体征、细胞免疫功能以及应激反应指标水平。结果 手术麻醉前、麻醉成功时及术后 72h,两组患者的心率、平均动脉压、脉搏氧饱和度(peripheral oxygen saturation,SpO2)及呼吸频率无显著差异(P > 0.05)。手术结束时、术后 24h 时,试验组患者的心率低于常规组,平均动脉压、SPO2 及呼吸频率均高于常规组,差异均有显著性(P < 0.05)。手术麻醉前、麻醉成功时,两组患者的 CD3+ T 细胞百分比、CD4+ T 细胞百分比、皮质醇及白介素 -6 水平无显著差异(P > 0.05)。手术结束时、术后 24h 及术后 72h,试验组患者的 CD3+ T 细胞百分比、CD4+ T 细胞百分比均高于常规组,皮质醇及白介素 -6 水平均低于常规组,差异均有显著性(P < 0.05)。结论 相对于传统开腹手术而言,单切口腹腔镜结肠癌根治术对于老年结直肠癌患者的影响更轻微,能够更好地稳定患者免疫能力,且应激反应轻微。

关键词: 结直肠癌, 单切口腹腔镜结肠癌根治术, 免疫能力, 应激反应

Abstract:

Objective To investigate the effect of single incision laparoscopic radical resection of colon cancer on postoperative immune ability and stress response in elderly patients with colorectal cancer. Method A total of 68 patients with colorectal cancer who received single incision laparoscopic treatment in the second geriatric hospital of Wuxi from May 2022 to May 2025 were selected and randomly divided into two groups, 34 cases in each group. The conventional group received conventional open surgery, and the experimental group received single incision laparoscopic radical resection of colon cancer. The physical signs, cellular immune function and stress response index levels of the two groups at different time points were compared. Result There were no signifi cant differences in heart rate, mean arterial pressure, pulse oxygen saturation (SpO2) and respiratory rate between the two groups before anesthesia, when anesthesia was successful and 72 hours after operation (P > 0.05). At the end of operation and 24 hours after operation, the heart rate of the experimental group was lower than that of the conventional group, and the mean arterial pressure, SpO2 and respiratory rate of the experimental group were higher than those of the conventional group, with significant differences (P < 0.05). There were no signifi cant diff erences in the percentages of CD3+T cells, CD4+T cells, cortisol and interleukin-6 between the two groups before and after anesthesia (P > 0.05). At the end of operation, 24 hours and 72 hours after operation, the percentages of CD3+ T cells and CD4+ T cells in the experimental group were higher than those in the conventional group, and the levels of cortisol and interleukin-6 were lower than those in the conventional group, with significant differences (P < 0.05). Conclusion Compared with traditional open surgery, single incision laparoscopic radical resection of colon cancer has less impact on elderly patients with colorectal cancer, can better stabilize the immune ability of patients, and the stress response is mild.

Key words: Colorectal cancer, Single-incision laparoscopic radical resection of colon cancer, Immunity, Stress response