摘要
目的:探讨加速康复外科对腹腔镜胃癌根治术患者炎症因子及免疫功能的影响。方法:将患者分为围手术期加速康复外科模式管理的观察组(n=40)与常规围手术期管理的对照组(n=40),比较两组患者各时段炎性介质(IL-6、IL-8及IL-10)及IgA、IgG、IgM、CD3^+、CD4^+、CD4^+/CD8^+免疫指标水平,并进行对比分析。结果:术后第1天、第3天、第7天,两组患者IL-6、IL-8均显著上升(P<0.05),对照组较观察组升高更明显(P<0.05)。术后第1天,两组患者IL-10较术前均明显升高(P<0.05),观察组升高更明显。术后第1天,两组患者IgA、IgG、IgM水平较术前均明显降低(P<0.05)。术后第3天,观察组IgA、IgG水平明显高于对照组(P<0.05);两组患者术后IgM水平无明显差异。术后第1天两组患者CD3^+较术前均明显降低(P<0.05),对照组下降更明显;观察组术后CD4^+水平与术前相比差异无统计学意义;对照组CD4^+水平明显低于术前(P<0.05)。术后第1天、第3天,两组患者CD8^+、CD4^+/CD8^+水平较术前明显降低(P<0.05),但两组间差异无统计学意义。结论:加速康复外科模式可减轻腹腔镜胃癌根治术后患者机体炎性反应,并保护机体免疫功能,减少过度炎症反应,同时可在一定程度上降低胃癌细胞的转移、复发。
Objective：To investigate the effect of enhanced recovery after surgery（ERAS） on inflammatory factor and immune function of patients with gastric cancer after laparoscopic radical resection.Methods：Patients were divided into ERAS group（observation group 40 cases） and the traditional methods of management group（control group,40 cases）.Each periods inflammatory medium（IL-6,IL-8 and IL-10） and IgA,IgG,IgM,CD3＋,CD4＋,CD4/CD8＋ immune index concentration were tested and analyzed in two groups.Results：On the postoperative 1st,3rd and 7th day,IL-6 and IL-8 significantly increased as compared to preoperative data in two groups（P〈 0.05）,but the parameters in control group were significantly higher than those in observation group（P〈 0.05）.On the postoperative 1 st day,IL-10 significantly increased as compared to preoperative data in two groups（P〈 0.05）,but the parameter in observation group was significantly higher.On the first day after operation,IgA,IgG and IgM were significantly decreased as compared to preoperative data in two groups（P〈 0.05）.On the postoperative 3rd day JgA and IgG level in observation group were significantly higher than those in control group（P〈 0.05）.There was no significant difference of IgM level between the two groups.On the first day after operation,CD3＋ were significantly decreased as compared with preoperative data in two groups（P〈 0.05）,but those in the control group decreased more obviously.In observation group,there was no significant difference in CD4＋ level between postoperative day and before operation.CD4＋ level was significantly decreased as compared to preoperative level in control group（P〈 0.05）.On the postoperative 1st,3rd day,CD8＋,CD4＋/CD8＋ level were significantly lower than those before operation in two groups（P〈 0.05）,but there was no significant difference between the two groups.Conclusions：ERAS can mitigates the immunologic response protect the immune function of gastric cancer patients after laparoscopic radical resection,decrease excessive inflammatory response,metastasis and recurrence of gastric carcinoma cells.
出处
《腹腔镜外科杂志》
2017年第1期30-35,共6页
Journal of Laparoscopic Surgery
基金
安徽省铜陵市卫生科研项目(编号:卫科研〔2015〕12号)
关键词
胃肿瘤
胃癌根治术
腹腔镜检查
加速康复外科
炎症因子
免疫功能
Stomach neoplasms
Radical operation for gastric cancer
Laparoscopy
Enhanced recovery after surgery
Inflammatory cytokines
Immune function
