腔镜与传统根治术对结直肠癌患者机体应激及细胞免疫力影响的对比研究

王永森; 谢贻祥; 王传思; 黄鸿武; 吴申伟

doi:10.16766/j.cnki.issn.1674-4152.2016.08.011

腔镜与传统根治术对结直肠癌患者机体应激及细胞免疫力影响的对比研究

doi: 10.16766/j.cnki.issn.1674-4152.2016.08.011

安徽医科大学附属六安医院普外科, 安徽六安 237005

基金项目:

2014年度省卫计委中医药科研课题立项(2014zy-53)

2013年度高校省级自然科学研究项目(KJ2013-2144)

详细信息

通讯作者:
王永森,E-mail:surgicaldoctor@163.com

中图分类号: R735.35;R735.37;730.56
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出版历程
- 收稿日期: 2016-03-28

A comparative study of endoscopic and open resection for colorectal cancer affecting body stress and cell immunity

Department of General Surgery,Lu’an Hospital Affiliated to Anhui Medical University,Lu’an,Anhui 237005,China

摘要

摘要: 目的探讨腔镜技术和开腹手术进行结直肠癌根治术对患者细胞免疫力以及机体应激的影响，从免疫学角度研究腔镜技术治疗直肠癌的优势。方法选40例结直肠癌患者随机分为2组:腔镜组(20例)在腔镜下行结直肠癌根治术；对照组(20例)采用开腹结直肠癌根治术。分别于术前及术后第1、3、7天抽外周静脉血测定CD3⁺、CD4⁺、CD8⁺ T细胞水平，可溶性白介素-2受体(Soluble interleukin-2 receptor，sIL-2R)及C反应蛋白(C-reactive protein,CRP)浓度，CD4⁺/CD8⁺ T细胞比值，并运用t检验对2组进行比较。结果术前所有指标2组差异无统计学意义(P＞0.05)。术后第1天CD3⁺、CD4⁺、CD8⁺ T细胞水平、CD4⁺/CD8⁺ T细胞比值、CRP浓度2组差异无统计学意义(P＞0.05)，腔镜组sIL-2R浓度低于对照组(P＜0.05)。术后第3天，腔镜组CD3⁺、CD4⁺ T细胞水平高于对照组(P＜0.05)，sIL-2R及CRP浓度低于对照组(P＜0.05)，CD8⁺T细胞水平、CD4⁺/CD8⁺ T细胞比值2组差异无统计学意义(P＞0.05)。术后第7天，腔镜组CRP浓度低于对照组(P＜0.05)，余指标2组差异无统计学意义(P＞0.05)。组内比较，术后第1、3、7天所有指标数值较术前明显下降(P＜0.05)。结论与传统的开腹手术相比，腹腔镜下进行结直肠癌根治术对于患者的早期细胞免疫力保护以及减少早期的应激反应有积极意义。
- 腹腔镜 /
- 结直肠癌 /
- 细胞免疫 /
- 应激反应
Abstract: Objective To explore the effect of laparoscopic and open radical operation for colorectal cancer on the cell immunity and body stress,and evaluate the advantage of laparoscopic technique in the treatment of rectal cancer from immunology perspective. Methods A total of 40 cases of colorectal cancer were randomly divided into 2 groups. The laparoscopic group(20 cases) received laparoscopic resection of colorectal cancer,while the control group(20 cases) received traditional open resection of colorectal cancer. The levels of CD3~+,CD4~+,CD8~+,s IL-2R,CRP were detected and compared one day before the surgery,and 1st,3rd and 7th day after the surgery. Results There was no significant difference in blood levels of all index between laparoscopic resection group and open operation group on first day before the surgery(all P > 0. 05). There was no significant difference in blood levels of CD3~+,CD4~+,CD8~+,CRP between laparoscopic resection group and open operation group on the first day after the surgery(all P > 0. 05),the level of s IL-2R in laparoscopic group was lower than that in open operation group,the difference was statistically significant(P < 0. 05). At third days after the operation,CD3~+,CD4~+,in the laparoscopic group was higher than that in the open operation group,the difference was statistically significant(P < 0. 05); s IL-2R and CRP were less than open surgery group,the difference was statistically significant(P < 0. 05),there was no significant difference between CD8~+and CD4~+/CD8~+(P > 0. 05). At seventh days after the operation,the level of CRP in the laparoscopic group was less than that in the open group,and the difference was statistically significant(P < 0. 05); The other was not significant(P > 0. 05). Compared with all index,first day,3rd and 7th day were significantly decreased,the difference was statistically significant(P < 0. 05). Conclusion Compared with the traditional open surgery,laparoscopic radical resection of colorectal cancer has positive significance in the protection of early cell immunity and reduction of early stress response.
- Laparoscope /
- Colorectal cancer /
- Cellular immunity /
- Stress response