腹腔镜手术与开腹手术对结肠癌患者胃肠功能和免疫功能的影响

Effect of laparoscopic surgery and laparotomy on gastrointestinal function and immune function in the patients with colon cancer

目的探讨腹腔镜手术与开腹手术对结肠癌患者胃肠功能和免疫功能的影响。方法选取本院2014年1月~2016年1月收治的100例结肠癌患者,根据临床术式不同将其分为观察组、对照组两组,每组各50例,对照组患者采用开腹手术,观察组患者采用腹腔镜手术。比较两组患者术后胃肠功能恢复情况,包括术后肠鸣音恢复时间、术后排气时间及两组患者手术前后各项免疫功能指标的变化情况。结果观察组患者术后肠鸣音恢复时间(37.8±9.1)min,术后排气时间(3.1±0.9)h,均显著短于对照组,差异有统计学意义(P<0.05)。对照组患者术后第1天CD4^+、CD4^+/CD8^+均较术前第1天显著升高,CD8^+较术前第1天显著降低,差异有统计学意义(P<0.05)。但观察组患者术后第1天CD4^+、CD8^+、CD4^+/CD8^+较术前第1天变化不显著,差异无统计学意义(P>0.05)。对照组患者术后第1天IgA、IgM、IgG均较术前第1天显著降低,差异有统计学意义(P<0.05)。但观察组患者术后第1天IgA、IgM、IgG均较术前第1天较变化不显著,差异无统计学意义(P>0.05)。结论结肠癌患者行腹腔镜手术有利于促进患者术后肠功能恢复,对免疫功能影响小,与开腹手术相比具有显著优势,值得推广和应用。

Objective To investigate the effects of laparoscopic surgery and laparotomy on gastrointestinal function and immune function in the patients with colon cancer. Methods A total of 100 patients with colorectal cancer who were admitted to our hospital from January 2014 to January 2016 were selected. They were divided into the observation group and the control group according to the different clinical procedures, with 50 cases in each group. The patients in the control group were treated with open surgery, and the patients in the observation group were treated with laparoscopic surgery. The recovery of gastrointestinal function was compared between the two groups of patients, including the recovery time of postoperative bowel sounds, postoperative time of passage of gas and the changes of immune function indices before and after the operation in the two groups were compared. Results The recovery time of postoperative bowel sound was（37.8±9.1） min and the time of postoperative passage of gas was（3.1±0.9） h in the observation group, which were significantly shorter than those in the control group, and the differences between two groups were statistically significant（P〈0.05）. The CD4^＋ and CD4^＋/CD8^＋ levels in the control group on the first day after the surgery were significantly higher than those on the first day before the surgery. CD8± was significantly lower than that on the first day before surgery, and the difference was statistically significant（P〈0.05）. However, CD4^＋,CD8^＋, and CD4^＋/CD8^＋ in the observation group had no significant change on the first day after the surgery compared with those on the first day before the surgery, and the differences between groups were not statistically significant（P〉0.05）. IgA, IgM and IgG in the control group on the first day after the surgery were signiiieanffy lower tfian tfiose on the first day betore tile surgery, and the differences was statistically significant（P〈0.05）. However, the changes of IgA, IgM and IgG in the observation group on the first day after the surgery were not significantly different from those on the first day before the surgery, and the differences were not statistically significant（P〉0.05）. Conclusion Laparoscopic surgery is helpful to promote the recovery of bowel function after surgery in the patients with colon cancer. It has minor effect on immune function and has significant advantages compared with laparotomy, which is worthy of promotion and application.