腹腔镜直肠癌根治性切除术对中性粒细胞呼吸暴发功能的影响

Effects of radical laparoscopic proctectomy for rectal carcinoma on neutrophil respiratory burst

目的 探讨腹腔镜及开腹手术后,二者中性粒细胞呼吸暴发(respiratoryburst)功能的变化,了解腹腔镜手术对中性粒细胞杀菌功能的影响。方法 选取“直肠恶性肿瘤”患者2 0例,随机分为两组各10例,腹腔镜组(Laparoscopy)行经腹腔镜直肠癌根治性切除术,开腹组(Open)行开腹直肠癌根治性切除术作为对照。于术前、术后即刻、术后2 4h及72h ,抽取外周静脉血,行血常规检查,并分离中性粒细胞,经佛波酯(PMA)刺激后,用流式细胞仪检测呼吸暴发强度。结果 腹腔镜直肠癌根治性切除术后,患者白细胞总数及中性粒细胞升高幅度及呼吸暴发强度在术后2 4及72h明显低于开腹直肠癌根治性切除术后(P <0 0 5 )。结论 腹腔镜直肠癌根治性切除术后,中性粒细胞杀菌功能低于开腹直肠癌根治性切除术后。

Objective To evaluate the effects of radical laparoscopic proctectomy for rectal cancer on neutrophil respiratory burst as compared with open proctectomy for rectal cancer. Methods Twenty patients scheduled for radical resection of rectal carcinoma were randomly assigned to undergo either a laparoscopic or conventional procedure. Heparinized peripheral blood samples were collected preoperatively, at 2 h, 24 h and 72 h after surgery and processed within 1 h. The total leucocyte and neutrophil count were evaluated. The PMA-stimulated neutrophil oxidative burst capacity was quantified by flow cytometry. Results An increase in overall peripheral leucocyte and neutrophil count following open and laparoscopic procedures was observed, but the former was more significant than the later (P<0.05) . The neutrophil oxidative burst capacity was significantly lower at 24 and 72 h after laparoscopic procedures, but not open procedures (P<0.01). Conclusion Reduced respiratory burst activity after laparoscopic proctectomy for rectal cancer was associated with impaired ability to kill bacteria and increased susceptibility to infectious diseases.