不同手术方式对直肠癌患者术后感染病原菌与免疫功能影响的研究

Influence of different surgical procedures on pathogen infections and immune function in colorectal cancer patients after surgery

目的探讨不同手术方式对直肠癌患者术后感染病原菌种类及免疫功能的影响,从而为选择合适的手术方案提供依据。方法选取2011年5月-2015年5月医院收治的直肠癌患者120例,根据手术方式将其分为腹腔镜组62例与传统开腹组58例,对术后感染患者进行病原菌培养和鉴定,并对免疫功能进行检测,数据采用SPSS 19.0软件进行统计分析。结果腹腔镜组患者感染率为19.35%,传统开腹组患者感染率为36.21%,两组比较差异有统计学意义(P<0.05);腹腔镜组患者共检出病原菌19株,其中革兰阳性菌占36.84%,革兰阴性菌占63.16%,传统开腹组患者共检出病原菌32株,其中革兰阳性菌占34.38%,革兰阴性菌占65.62%,两组病原菌分布差异无统计学意义;腹腔镜组患者术后干扰素-γ(IFN-γ)、白细胞介素-2(IL-2)水平与传统开腹组患者相比明显升高,白细胞介素-10(IL-10)下降,两组比较差异有统计学意义(P<0.05)。结论腹腔镜手术治疗直肠癌患者可以降低术后感染率,且免疫功能恢复更快,与传统开腹手术相比,具有很大优势。

OBJECTIVE To investigate the effects of different surgical methods on postoperative pathogenic infections and immune function in patients with colorectal cancer,so as to provide the basis for the selection of the appropriate surgical plan.METHODS Totally 120 colorectal cancer patients admitted to hospital during May 2011-May 2015 were selected and divided into the laparoscopic group（n=62）and the conventional laparotomy group（n=58）according to surgical procedures.Culture and identification of pathogens were performed for patients with postoperative infections,and the immune function was detected.Data were statistically analyzed by software SPSS19.0.RESULTS The infection rate was 19.35%for the laparoscopic group and 36.21%for the traditional laparotomy group,the difference was significant（P〈0.05）.Totally 19 pathogens were detected in the laparoscopic group,including gram-positive bacteria accounting for 36.84%,gram-negative bacteria accounting for 63.16%.And 32 pathogens were detected in the conventional laparotomy group,including gram-positive bacteria accounting for 34.38%,gram-negative bacteria accounting for 65.62%,the two groups was not significant in distribution of pathogens.Postoperative IFN-γand IL-2 were significantly higher and IL-10 was decreased in the laparoscopic group compared to the conventional laparotomy group（P〈0.05）.CONCLUSIONLaparoscopic surgery for colorectal cancer patients can reduce postoperative infection rates and make immune function recovery faster,which has great advantages compared to conventional laparotomy.