后腹腔镜切除术对老年T2期肾细胞癌患者免疫功能与神经内分泌功能的影响

Effects of Retroperitoneal Laparoscopic Resection on Immune Function and Neuroendocrine Function in Elderly Patients with T2-type Renal Cell Carcinoma

目的探讨后腹腔镜切除术治疗老年T2期肾细胞癌的效果及其对患者免疫功能与神经内分泌功能的影响。方法选取100例老年T2期肾细胞癌患者作为观察对象,随机分为观察组与对照组,每组50例。对照组采取传统开放式手术,观察组则采取后腹腔镜切除术。观察2组患者的手术评价指标(手术时间、术中出血量、术后排气时间、术后引流量、术区拔管时间及术后住院时间),并分析2组患者手术前、术后1 d免疫功能(T淋巴细胞亚群CD3^+、CD4^+、CD4^+/CD8^+)与神经内分泌功能(血清β-内啡肽、胰高血糖素、皮质醇、促肾上腺皮质激素)的变化情况。结果观察组在各方面均优于对照组(P<0.05)。结论后腹腔镜切除术在老年T2期肾细胞癌治疗中具有较好的应用效果,能够有效缩短患者的住院时间,同时对患者免疫功能与神经内分泌功能的影响低于开放式手术,值得在临床中推广使用。

Objective To analyze the effect of retroperitoneal laparoscopic resection of T2 on renal cell carcinoma and its effect on immune function and neuroendocrine function. Methods 100 elderly patients with T2 stage renal cell carcinoma were randomly divided into the observation group and the control group（ n = 50）. The control group received traditional open surgery,the observation group was taken after laparoscopic resection. The operative evaluation index（ operation time,intraoperative blood loss,postoperative exhaust time,postoperative drainage volume,extubation time and postoperative hospital stay） were observed in the 2 groups. The patients were treated before and after operation（ T lymphocyte subsets CD3~＋,CD4~＋,CD4~＋/CD8~＋）and neuroendocrine function（ serum β-endorphin,glucagon,cortisol and adrenocorticotropic hormone）. Results The observation group was superior to the control group in all aspects（ P〈0. 05）. Conclusion Posterior laparoscopic resection has a good effect in the treatment of elderly patients with T2 stage renal cell carcinoma. It can effectively shorten the hospital stay,and the effect of immune function and neuroendocrine function is lower than that of open surgery. It is worthy of clinical promotion.