腹腔镜胃癌根治术对患者术后自然杀伤细胞比例的影响

The influence of laparoscopic radical operation for gastric carcinoma on the proportion of natural killer( NK) cells

目的探讨腹腔镜胃癌根治术对患者术后自然杀伤(NK)细胞比例的影响。方法选取行胃癌根治术的患者152例,根据手术方式不同,将患者分为腹腔镜组(行腹腔镜胃癌根治术,74例)和开腹组(行开腹胃癌根治术,78例),通过流式细胞仪检测胃癌患者外周静脉血中NK细胞的比例,分析两组患者术前1 d、术后2 d、术后1周及术后2周NK细胞比例的变化,探讨不同手术方式对机体免疫功能的影响。结果腹腔镜组患者的手术时间、术中出血量、肛门排气时间及住院时间均明显少于开腹组,差异有统计学意义(均P<0.05)。术后2 d与术前1 d比较,腹腔镜组和开腹组患者NK细胞比例均明显下降,差异有统计学意义(P<0.05);腹腔镜组患者术后1周NK细胞比例恢复近术前水平,而开腹组患者术后1周NK细胞比例仍处于低水平,术后2周才恢复近术前水平;腹腔镜组和开腹组患者NK细胞比例变化比较,差异有统计学意义(P<0.05)。结论与传统开腹胃癌根治术相比,腹腔镜胃癌根治术对机体损伤小,能够保护机体免疫功能,术后患者恢复快,值得临床推广应用。

Objective To study the influence of laparoscopic radical operation for gastric carcino- ma on the proportion of natural killer （NK） cells. Methods 152 patients with gastric cancer were enrolled into this study. According to the operation method, patients were divided into laparoscopy group （74 cases） and laparotomy group （78 cases）. The change of the proportion of natural killer （NK） cells in preoperative 1 day, postoperative 2 days, postoperative 1 week and 2 weeks were analyzed and compared, and the influ- ence of different surgical methods on the body＇s immune function were explored. Results Operation time, intraoperative blood loss and length of hospital stay in the laparoscopy group were less than that in the lapa- rotomy group, and the differences were significant （P 〈 0.05 ）. Compared with preoperative 1 days, the ra- tio of NK cells of postoperative 2 days in laparoscopy group pand laparotomy group were significantly re- duced, the difference were significant （ P 〈 0. 05 ） ; The level of the percentage of NK cells in laparoscopic group recovered as nearly preoperative level in postoperative 1 week, but that in the laparotomy group was still at low level, and recovered as nearly preoperative level in postoperative 2 weeks; The percentages of NK cells between laparoscopy and laparotomy groups had significant difference （P 〈 0. 05）. Conclusion Compared with open gastric cancer radical prostatectomy, laparoscopic gastric cancer radical has little dam- age to the body. It has the advantages of protection of the body＇s immune function, patients with postopera- tive recovery fast, and it worth to be promoted in clinicalpraetice.