摘要
目的探讨腹腔镜手术治疗结肠癌和炎症性肠病的疗效及对机体免疫功能的影响。方法选择2014年6月~2016年6月我院行开腹手术的结肠癌、炎症性肠病患者20例设为对照组,采用腹腔镜手术治疗结肠癌、炎症性肠病患者32例设为腹腔镜组,比较两组患者的各项手术指标及并发症情况,并采用流式细胞仪测定两组患者术前及术后的免疫指标CD3^+、CD4^+、CD8^+及CD4^+/CD8^+比值。结果腹腔镜组的术中出血量(113.6±21.6)m L,明显少于对照组;腹腔镜组患者术后肠功能恢复时间(4.3±1.1)d,住院时间(6.9±1.3)d,均明显短于对照组。腹腔镜组术后并发症的发生率显著低于对照组(P<0.05)。术后腹腔镜组患者的免疫指标CD3^+、CD4^+水平为(35.43±6.02)%、(30.35±10.38)%,分别与对照组进行对比显示降低幅度小(P<0.05)。术后腹腔镜组患者的CD4^+/CD8^+比值较术前显著升高,但没有对照组升高幅度大(P<0.05)。结论腹腔镜手术治疗结肠癌和炎症性肠病除了具有创伤小、术中出血少及并发症少、术后恢复快等优点,腹腔镜手术对机体免疫功能的抑制程度较开腹手术轻,说明腹腔镜手术利于改善患者的预后。
Objective To investigate the curative effect of laparoscopic surgery in the treatment of colon cancer and in- flammatory bowel disease and its effect on immune function. Methods 20 patients with colon cancer and inflammatory bowel disease who were given laparotomy in our hospital from June 2014 to June 2016 were selected and were assigned into the control group. Another 32 patients who were given the surgery of laparoscopic colon cancer and inflammatory bowel disease were assigned to the laparoseopy group. Various surgical indicators and complications were compared be- tween the two groups, and immune indicators of CD3^＋, CD4^＋, CD8^＋ and CD4^＋/CD8^＋ before and after the surgery were measured by flow cytometry. Results The intraoperative blood loss was（113.6±21.6） mL in the laparoscopy group, which was significantly less than that in the control group. The postoperative recovery time of bowel function was（4.3±l.1） d and hospital stay was （6.9±1.3） d in the laparoscopy group, which were both significantly shorter than those in the control group. The incidence rate of postoperative complications in the laparoseopy group was significantly lower than that in the control group（P〈0.05）. The levels of CD3^＋ and CD4^＋ in the laparoscopy group were（35.43±6.02）% and（30.35±10.38）% respectively after the surgery, which were compared with those in the control group, showing a lower degree of reduction （P〈0.05）. The ratio of CD4^＋/CD8^＋ in the patients in the laparoscopy group was significantly higher than that before the surgery, but the degree of increase was not larger than that in the control group（P〈0.05）. Conclusion Laparoscopic surgery in the treatment of colon cancer and inflammatory bowel disease has the advantages of less trauma, less intra- operative bleeding, less complications and rapid recovery after surgery. The degree of the immune suppression by la- paroscopie surgery is smaller than that of laparotomy, indicating that the laparoscopic surgery is beneficial to improving the prognosis of patients.
出处
《中国现代医生》
2017年第2期36-38,41,共4页
China Modern Doctor
基金
浙江省医药卫生科技计划项目(2013KYB251)
关键词
结肠癌
炎症性肠病
腹腔镜手术
免疫功能
Colon cancer
Inflammatory bowel disease
Laparoscopic surgery
Immune function
