3D腹腔镜下结直肠癌根治术对患者免疫功能及生理功能的影响

The influence of 3D laparoscopic surgery for colorectal cancer on patients' immune function and physiological function

目的:探讨3D腹腔镜下结直肠癌根治术对患者应激反应、免疫功能及生理功能的影响。方法:选择2012年9月至2017年9月江苏省连云港市赣榆区人民医院收治的结直肠癌患者100例,按照随机数字表法分为研究组和对照组,每组50例。研究组给予3D腹腔镜手术进行治疗,对照组给予传统开腹手术进行治疗。观察比较两组患者的手术情况、术后恢复状况、血浆白介素(IL)-6、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)水平、血清免疫球蛋白水平以及生理功能。结果:两组患者肠管切除长度、手术用时以及淋巴结清除数目比较,差异均无统计学意义(均P>0.05)。研究组术中出血量少于对照组,下床活动时间、术后排气时间以及住院时间均显著短于对照组(均P<0.05)。治疗后,两组患者血清IL-6、TNF-α和CRP水平均显著升高(P<0.05),但研究组显著低于对照组(P<0.05)。术后3d,两组患者血清IgA、IgM和IgG水平均较术前显著下降(P<0.05),且研究组显著高于对照组(P<0.05);术后7d,研究组患者血清IgA、IgM和IgG水平基本恢复至治疗前。治疗前,两组患者的胃动素和胃泌素水平无明显差异(P>0.05),治疗后,研究组胃动素和胃泌素略有下降,但与治疗前无明显差异(P>0.05),对照组胃动素和胃泌素水平较治疗前及研究组显著下降(P<0.05)。结论:3D腹腔镜结直肠癌根治术对患者应激反应、炎症反应及免疫抑制的影响较开腹手术轻,能有效促进患者生理功能的恢复。

Objective：To investigate the effects of 3 Dlaparoscopic surgery for colorectal cancer on patients’ immune function and physiological function.Methods：A total of 100 patients with colorectal cancer treated in our hospital from September 2012 to September 2017 were selected,and randomly divided into a control group and a study group,with 50 cases in each group.The patients in the study group received 3 Dlaparoscopic surgery,and those in the control group received traditional laparotomy.The interleukin-6（IL-6）,tumor necrosis factor-α（TNF-α）and C-reactive protein（CRP）levels in plasma as well as the immunoglobulin（Ig）A,IgM and IgG levels in serum were measured.The surgery-related indexes and physiological function were observed and compared.Results：There were no significant differences in the bowel resection length,the operation time and the number of resected lymph nodes between the two groups（P〉0.05）.The intraoperative blood-loss volume,time to get out of bed,postoperative exhaust time and hospital days in the study group were markedly lower than those in the control group（P〈0.05）.After treatment,the levels of IL-6,TNF-αand CRP in both groups were increased（P〈0.05）,and the increase was more significant in the study group compared with the control group（P〈0.05）.The IgA,IgM and IgG levels in both groups were decreased at 3 days post-operation（P〈0.05）,and were higher in the study group than that in the control group（P〈0.05）.After 7 days of the treatment,the IgA,IgM and IgG levels in the study group were nearly recovered to the normal levels.The levels of motilin and gastrin before and after surgery were similar in the study group（P 〉0.05）.However,the patients in the control group demonstrated significant decreases in the concentrations of IgA,IgM and IgG after surgery（P〈0.05）.Conclusion：3 Dlaparoscopic surgery for colorectal cancer had little impact on the stress response,inflammatory reaction and immune function of patients.It could promote the recovery of physiological function.