不同手术方式对直肠癌患者感染与免疫功能的影响分析

Influence of different surgical procedures on the infection and immune function of patients with rectal cancer

目的研究直肠癌患者采用不同手术方式对免疫功能及感染的影响,为临床指导治疗提供依据。方法选择医院2012年6月-2014年6月外科收治的直肠癌患者106例,所有患者均需手术治疗,根据入院顺序将患者分为对照组和观察组,每组各53例,对照组患者采用传统开腹手术进行治疗,观察组患者采用腹腔镜手术进行治疗,观察两组患者手术情况、术后感染以及免疫功能等。结果观察组患者手术时间、出血量、肛门排气时间以及住院时间均优于对照组,差异有统计学意义(P<0.05);术前两组患者CD_3^+、CD_4^+、CD_8^+及CD_4^+/CD_8^+水平差异无统计学意义;术后1、7d,观察组患者T淋巴细胞亚群水平明显高于对照组,差异有统计学意义(P<0.05);术前两组患者免疫球蛋白IgA、IgG、IgM以及炎症因子CRP、TNF-α、IL-6水平均差异无统计学意义;术后1、7d,观察组患者除TNF-α水平高于对照组,其余指标水平均明显低于对照组,差异有统计学意义(P<0.05)。结论直肠癌患者采用腹腔镜手术治疗术后感染情况小,炎症反应小,对免疫功能影响有限,有助于患者术后恢复。

OBJECTIVE To study the effect of different surgical methods on immune function and infection in patients with rectal cancer so as to provide the basis for clinical treatment.METHODS A total of 106 cases of patients with rectal cancer treated in our hospital from Jun.2012 to Jun.2014 were included.All patients underwent surgical treatment.The patients were divided into two groups according to the order of admission,53 cases in each group.Of them,53 cases were treated by traditional open surgery as control group,and the other 53 cases were treated with laparoscopic operation as the observation group.The surgery effect,postoperative infection and immune function were observed.RESULTS The operation time,bleeding volume,anal exhaust time and hospitalization time in observation group were better than those of the control group.The differences were statistically significant（P〈0.05）.There were no significant differences in CD3^＋,CD8^＋,CD4^＋and CD4^＋/CD8^＋levels in two groups.The levels of IgA,IgM,IgG and inflammatory factors CRP,TNF-αand IL-6in the two groups were not different.After 1dand 7d,the levels of TNF-αin the observation group were significantly higher than those in the control group,and the level of the other indexes was significantly lower than that of the control group（P〈0.05）.CONCLUSIONThe inflammatory reaction is small and the influence of the immune function is limited when treating rectal cancer patients with laparoscopic surgery,which is helpful for the recovery of patients after operation.