| 严士光,丁友宏,罗志海,曹海英,李向阳.腹腔镜全结肠系膜切除术对结肠癌患者应激反应与免疫功能的影响[J].,2017,17(24):4747-4750 |
| 腹腔镜全结肠系膜切除术对结肠癌患者应激反应与免疫功能的影响 |
| Effects of Laparoscopy Assisted Complete Mesocolon Resection on the Stress Response and Immune Function of Patients with Colon Cancer |
| 投稿时间：2016-11-15 修订日期：2016-12-10 |
| DOI：10.13241/j.cnki.pmb.2017.24.036 |
| 中文关键词: 结肠癌 腹腔镜全结肠系膜切除术 免疫功能 白介素-6 肿瘤坏死因子-α |
| 英文关键词: Colon cancer Laparoscopy assisted complete mesocolon resection Immune function IL-6 TNF-α |
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| 摘要 目的：探讨腹腔镜全结肠系膜切除术对结肠癌患者应激反应与免疫功能的影响。方法：选择2013年1月到2016年1月在我院进行诊治的结肠癌患者130例，根据随机信封抽签原则分为观察组与对照组各65例，观察组采用腹腔镜全结肠系膜切除术，对照组采用开腹手术治疗，比较两组患者治疗前后血清IL-6和TNF-α值、CD4+细胞含量的变化情况，术中出血量、术后肠道恢复时间、术后住院时间以及并发症的发生情况。结果：两组患者均顺利完成手术，术中无严重并发症发生，观察组的术中出血量、术后肠道恢复时间与术后住院时间明显少于对照组(P<0.05)。观察组术后14 d的乳糜漏、伤口感染、肺部感染等并发症发生率为1.5%，明显低于对照组的12.3%(P<0.05)。观察组与对照组术后14 d的CD4+细胞含量分别为36.34±7.83%和33.66±9.82%，都明显高于术前的30.33±6.49%和30.49±5.33%(P<0.05)，且观察组明显高于对照组(P<0.05)。观察组与对照组术后14 d的血清白介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)值都明显低于治疗前(P<0.05)，同时术后14 d观察组的血清IL-6和TNF-α值明显低于对照组(P<0.05)。结论：腹腔镜全结肠系膜切除术能有效提高结肠癌患者的免疫功能，抑制其应激反映，从而促进患者康复，减少术后并发症的发生。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the effects of laparoscopy assisted complete mesocolon resection on the stress response and immune function of patients with colon cancer. Methods: From January 2013 to January 2016, 130 patients with colon cancer in our hospital were selected and randomly divided into the observation group and the control group with 65 cases in each group according to the random lottery envelopes. The observation group was treated with laparoscopy assisted complete mesocolon resection, the control group was treated with open operation. The changes of serum IL-6, TNF-α and amouts of CD4+ cells, blood loss, bowel function restoration time, hospital stays and complication rate of two groups were compared before and after treatment. Results: Both groups of patients were successfully completed the surgery and there was no serious complications occurred in both groups. The amount of bleeding, postoperative intestinal recovery time and postoperative hospital stay in the observation group were significantly less than those of the control group (P<0.05). The chylous fistula, wound infection, pulmonary infection and complication rate on the 14th day postoperation in the observation group was 1.5%, which was 12.3% in the control group and significantly higher than that of the control group (P<0.05). The contents of CD4+ cells in the observation group and the control group were 36.34±7.83% and 33.66±9.82%, respectively, which were significantly higher than those before treatment(30.33±6.49% and 30.49±5.33%)(P<0.05), and the contents of CD4+ cells of observation group was significantly higher than that of the control group after treatment(P<0.05). The serum levels of IL-6 and TNF-α in both groups were significantly lower than those before treatment on the 14th day postoperation(P<0.05), and the serum IL-6 and TNF-α levels of observation group were significantly lower than those in the control group on the 14th day postoperation (P<0.05). Conclusion: Laparoscopy assisted complete mesocolon resection could promote the immune function and inhibit the stress response, which further promoted the rehabilitation and induced the complications in the treatment of patients with colon cancer. |
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