腹腔镜辅助胃癌根治术对胃癌患者的炎症反应及免疫功能的影响

Effect of laparoscopic-assisted radical gastrectomy on inflammatory response and immune function in patients with gastric cancer

目的探讨腹腔镜辅助胃癌根治术对胃癌患者的炎症反应、免疫功能的影响。方法选取2016年5月至2021年5月联勤保障部队第九〇〇医院收治的196例胃癌患者作为研究对象,按照随机数字表法分为腹腔镜组与开腹组,各98例。开腹组行开腹胃癌根治术,腹腔镜组行腹腔镜辅助胃癌根治术,比较两组围手术期指标、炎症因子[白细胞介素-10(IL-10)、白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CRP)]、免疫功能(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))。结果腹腔镜组肛门排气时间、首次进食时间、术后住院时间均短于开腹组,差异有统计学意义(P<0.05)。术后1周,两组IL-10、IL-6、hs-CRP水平均高于术前,CD4^(+)、CD8^(+)、CD3^(+)水平及CD4^(+)/CD8^(+)均低于术前,且腹腔镜组IL-10、CD4^(+)、CD3^(+)水平及CD4^(+)/CD8^(+)均高于开腹组,但IL-6、hs-CRP、CD8^(+)水平均低于开腹组,差异有统计学意义(P<0.05)。结论腹腔镜辅助胃癌根治术治疗胃癌患者疗效显著,手术切口较小,有利于患者术后恢复,可改善其免疫功能及减轻术后炎症反应,值得临床推广应用。

Objective To investigate the effect of laparoscopic assisted radical gastrectomy on inflammatory response and immune function in patients with gastric cancer.Methods 196 patients with gastric cancer admitted to the 900th Hospital of Joint Logistics Support Force from May 2016 to May 2021 were selected as the research subjects,they were divided into the abdominal group and the laparotomy group according to the ran-dom number table method,with 98 cases in each group.The laparotomy group underwent open radical gastrectomy for gastric cancer,and the abdom-inal group underwent laparoscopic-assisted radical gastrectomy for gastric cancer,the perioperative indicators,inflammatory factors(interleukin-10[IL-10],interleukin-6[IL-6],hypersensitive C-reactive protein[hs-CRP]),immune function(CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+))were compared be-tween the two groups.Results The anal exhaust time,first feeding time and postoperative hospital stay in the abdominal group were shorter than those in the laparotomy group,and the differences were statistically significant(P<0.05).1 week after operation,the levels of IL-10,IL-6 and hs-CRP of the two groups were higher than those before operation,the levels of CD3^(+),CD4^(+),CD8^(+)and CD4^(+)/CD8^(+)were lower than those before opera-tion,and the levels of IL-10,CD4^(+),CD8^(+)and CD4^(+)/CD8^(+)in the abdominal group were higher than those in the laparotomy group,but the levels of IL-6,hs-CRP and CD8^(+)were lower than those in the laparotomy group,the differences were statistically significant(P<0.05).Conclusion Com-pared with open radical gastrectomy,laparoscopic assisted radical gastrectomy has smaller wound,which is beneficial to the recovery of patients,it can improve the immune function of patients and reduce their postoperative inflammatory response,it is worthy of clinical promotion and application.