结直肠癌腹腔镜与开腹手术对免疫功能的影响分析

Impact of colorectal cancer laparoscopic and open surgery on immune function

目的:分析对比结直肠癌腹腔镜与开腹手术对免疫功能的影响。方法:选取我科2010年1月至2013年12月因结直肠癌入院行手术治疗的患者共85例,随机分为实验组和对照组。实验组行腹腔镜手术,对照组行开腹手术。对比两组患者术前及术后1 d、7 d的外周血淋巴细胞各亚群变化、免疫球蛋白、CRP和IL-6水平、NO和活性氧物质(Reactive oxygen species,ROS)水平。结果:两组患者术后1 d、7 d的CD3、CD4、CD4/CD8水平显著低于术前,CD8显著高于术前,P<0.05;实验组术后1 d、7 d的CD3、CD4、CD4/CD8水平显著高于对照组,CD8显著低于对照组,P<0.05。两组患者术后1 d、7 d的IL-6、CRP水平显著高于术前,IgG、Ig M和Ig A显著低于术前,P<0.05;实验组术后1 d、7 d的IL-6、CRP水平显著低于对照组,IgG、Ig M和Ig A显著高于对照组,P<0.05。对照组术后1 d、7 d的NO和ROS水平显著高于术前和实验组术后同期,P<0.05;实验组术后1 d、7 d的NO和ROS水平与术前无显著差异,P>0.05。结论:腹腔镜治疗结直肠癌和开腹手术相比,对于人体免疫功能影响更小,具有一定的保护作用。

Objective： To analyze the impact of colorectal cancer laparoscopic and open surgery on immune function. Methods： 85 patients from January 2010 to December 2013 due to surgical treatment of colorectal cancer hospitalized in our department were randomly divided into experimental and control groups. The experimental group underwent laparoscopic surgery, the control group underwent laparotomy. The peripheral blood lymphocyte subsets, immunoglobulins, CRP and IL-6 levels, NO and ROS levels were compared in two groups of patients before and after one day, seven days of surgery. Results： The postoperative CD3, CIM ,CD4/CD8 level after one day and seven days of surgery was significantly lower than before surgery, CD8 was significantly higher than before surgery,P〈0.05. The postoperative CD3, CIM, CD4/CD8 level after one clay and seven days in the experimental group were significantly higher, CD8 was significantly lower than the control group, P〈0. 05. The postoperative IL-6, CRP levels after one day and seven days of surgery were significantly higher than before surgery, IgG, IgM and IgA were significantly lower than before surgery, P〈 0. 05. The postoperative IL-6, CRP levels after one day and seven days of surgery in the experimental group were significantly lower than the control group,IgG,IgM and IgA were significantly higher,P〈0. 05. The NO and ROS levels after one day and seven days of surgery in the control group were significantly higher than the preoperative and postoperative period the experimental group, P〈0. 05. The NO and ROS levels after one day and seven days of surgery in the experimental group were no significant difference, P〉 0. 05. Conclusion： Compared to open surgery,laparoscopic treatment of colorectal cancer has a protective and smaller effect for the body＇s immune func- tion.