腹腔镜胃癌根治术的疗效及对患者免疫功能的影响

Efficacy of laparoscopic radical operation for gastric cancer and its influence on the immune function

目的分析探讨腹腔镜胃癌根治术的疗效及对患者免疫功能的影响。方法选取2010年1月一2012年7月于本院接受诊断和治疗的胃癌患者86例,随机分为观察组和对照组,每组43例。对照组给予传统开腹式胃癌根治术治疗,观察组给予腹腔镜胃癌根治术治疗,比较2组术中及术后恢复情况(术中出血量、首次排气时间、下床活动时间、止痛药物使用次数、首次进食时间和住院时间)、术后10 d免疫功能(CD_3^+、CD_4^+、CD_8^+、CD_4^+/CD_8^+水平和NK细胞百分比)改变情况,以及术后并发症发生情况。结果观察组患者在术中出血量、首次排气时间、下床活动时间、止痛药物使用次数、首次进食时间和住院时间方面均明显优于对照组,差异有统计学意义(P<0.05)。2组患者术后10 d在CD_3^+、CD_4^+、CD_8^+、CD_4^+/CD_8^+水平方面均明显降低,且观察组显著优于对照组,差异有统计学意义(P<0.05)。2组并发症发生情况比较差异无统计学意义(P<0.05)。结论腹腔镜胃癌根治术临床疗效显著,能明显改善术后恢复,并发症较少,且对机体免疫功能影响较小,值得临床推广应用。

Objective To explore efficacy of laparoscopic radical operation for gastric cancer and analyze its influence on immune function.Methods 86 patients with gastric cancer were ran-domly divided into observation group and control group,43 cases in each group.The control group received conventional open type gastric cancer treatment,while observation group received laparo-scopic radical gastrectomy treatment.Blood loss,the first exhaust time,ambulation time,the fre-quency of use of pain medications,first feeding time and length of stay were compared,and immune function after 10 days of treatment（CD3,CD4,CD8,CD4 /CD8 levels and the percentage of NK cells）as well as the incidence rate of postoperative complications were compared.Results Intraop-erative blood loss,the first exhaust time,ambulation time,the frequency of pain medications,first feeding time and hospital stay in the observation group were significantly better than the control group （P 〈0.05 ）.10 days after treatment,CD3,CD4,CD8,CD4 /CD8 levels in both groups sig-nificantly reduced,and of which in the observation group were significantly better than the control group （P 〈0.05）.There was no significant difference of complications between two groups （P 〈0.05）.Conclusion Laparoscopic radical operation for gastric cancer can significantly improve post-operative recovery,reduce incidence of complications and cause less influence on immune function, so it is worthy of clinical application.