胸腔镜肺癌根治术与开胸肺癌根治术患者围术期免疫指标及应急激素对比

Comparative analysis of perioperative immunology parameters and stress hormone in patients with lung cancer after two kind of radical operations

目的:对比采用胸腔镜肺癌根治术与开胸肺癌根治术两种治疗方法的肺癌患者围术期免疫指标及应急激素指标,为临床手术提供参考依据。方法:选取72例肺癌患者,根据手术方式的不同将其分为观察组与对照组,每组36例。观察组采用胸腔镜肺癌根治术,对照组采用开胸肺癌根治术,对比两组术前及术后3 d患者红细胞免疫指标、细胞免疫指标、应激激素及血液流变学指标情况。结果:术后3 d观察组红细胞C3b受体(RBC-C3b)和红细胞粘附促进因子(RFER)水平均显著高于对照组,差异有统计学意义(t=7.223,t=7.019;P<0.05),红细胞免疫复合物(RBC-IC)和红细胞抑制因子(RFIR)则显著低于对照组,差异有统计学意义(t=8.843,t=7.876;P<0.05);术后3 d观察组T淋巴细胞亚群、诱导T淋巴细胞(CD3^+、CD4^+、CD3^+CD4^+)均显著高于对照组,差异有统计学意义(t=9.454,t=8.749,t=11.451;P<0.05);CD8^+则显著低于对照组,差异有统计学意义(t=10.451,P<0.05);术后3 d观察组血清去甲肾上腺素(NE)、皮质醇(Cor)及血管紧张素Ⅱ(Ang-Ⅱ)水平均显著高于对照组,差异有统计学意义(t=2.181,t=10.320,t=5.924;P<0.05);术后3 d观察组血浆黏度、血沉方程K值均显著低于对照组,差异有统计学意义(t=29.698,t=7.411;P<0.05)。结论:胸腔镜肺癌根治术对患者不良影响较小,与开胸根治术相比更具安全性。

Objective： To compare the immunology parameters and stress hormone in two groups of patients with lung cancer after radical operation and provide reference to clinical surgery. Methods： From March 2015 to March 2016, 72 cases in our hospital were accepted surgical treatment for lung cancer and divided into observation group and control group. Among them 36 cases of video-assisted thoracoscopy lung cancer radical surgery for the treatment of patients in mind as the observation group, 36 cases of open chest lung cancer radical operation were recorded as control group, respectively comparing two groups of patients with preoperative and postoperative 3 days red cell immune index, index of cellular immunity, stress hormone level and blood rheology index. Results： 3 days after operation, the observation group in terms of RBC-C3 b, RFER levels were significantly higher than those of control group and RBC-IC and RFER were significantly lower than those in the control group. 3 days after operation, the observation group CD3^＋, CD4^＋, CD3^＋CD4^＋ were significantly higher than those of the control group, while CD8^＋ was significantly lower than that of the control group. 3 days after operation, the observation group NE, Cor, angiotensin II（ANG II） was significantly higher than that of the control group（t=2.181, t=10.320, t=5.924; P〈0.05）. 3 days after operation in observation group, the plasma viscosity, erythrocyte sedimentation equation K value were significantly lower than those in the control group. The differences were statistically significant（t=29.698, t=7.411; P〈0.05）. Conclusion： The side-effect of thoracoscopy radical resection of lung cancer is small, and it has more advantages compared with open chest lung cancer radical operation.