直肠癌行腹腔镜与开放术后感染致病菌分析与干扰素、白介素水平观察

Distributions of pathogenic bacteria and levels of interferon and interleukin in rectal cancer patients after laparoscopic surgery or open surgery

目的观察腹腔镜与开放术治疗直肠癌术后感染的致病菌分布情况以及对干扰素、白介素体内水平的影响。方法自广东省惠州市中心人民医院2014年1月~2015年12月间采取手术治疗的直肠癌患者中,择取43例腹腔镜下手术治疗的患者纳入腹腔镜组,另择取43例开放术治疗的患者纳入开放组中,统计两组术后感染的发生率,检测两组术后感染患者的致病菌以及干扰素-γ(IFN-γ)、白介素-2(IL-2)、白介素-10(IL-10)的水平并进行统计学分析。结果腹腔镜组术后感染发生率为6.98%,开放组术后感染发生率为23.26%;两组感染率差别有统计学意义并且腹腔镜组低于开放组(P<0.05)。开放组共检出致病菌株24株,其中革兰阴性菌分布占比为66.67%,革兰阳性菌占比为33.33%;腹腔镜组共检出致病菌株11株,其中革兰阴性菌分布占比为63.64%,革兰阳性菌占比为36.36%;腹腔镜组检出致病菌株数显著低于开放组(P<0.05)。术后腹腔镜组IL-2、IL-10、IFN-γ的水平均优于开放组(P<0.05)。结论腹腔镜手术治疗直肠癌患者具有降低术后致病菌感染概率的优势,对于自身免疫功能的损伤较轻,有利于术后尽早恢复,与传统开放术相比优势更加明显,值得在直肠癌手术治疗中推广应用。

Objective To investigate the distribution of pathogenic bacteria and its influence on the level ofinterferon and interleukin in patients with rectal cancer after laparoscopic surgery or open surgery.Methods Thepatients with rectal cancer going through surgery treatment from Huizhou Central Hospital From January2014to December2015were recruited,in which43patients undergoing laparoscopic surgery were included into thelaparoscopic group,and other43patients undergoing open surgery were selected into the open group.The incidenceof postoperative infection in the two groups was calculated and levels of pathogenic bacteria,gamma interferon(IFN-γ),interleukin-2(IL-2)and interleukin-10(IL-10)were analyzed.Results The incidence of postoperative infectionin laparoscopic group was6.98%,while the incidence of postoperative infection in the open group was23.26%.There was significant difference in the two groups and the incidence of postoperative infection on laparoscopic groupwas lower than the open group(P<0.05).24pathogenic strains were detected in the open group.The proportionof gram-negative bacteria was66.67%,while gram-positive bacteria accounted for33.33%.11pathogenic strainswere detected in the laparoscopic group,in which gram-negative bacteria accounted for63.64%and grampositivebacteria accounted for36.36%.The detected number of pathogenic bacteria in the laparoscopic group wassignificantly lower than that in the open group(P<0.05).The level of IL-2,IL-10and IFN-γin the laparoscopicgroup were significantly higher than those in the open group(P<0.05).Conclusion Comparing with the traditionalopen surgery,laparoscopic surgery for patients with rectal cancer has the advantage of reducing the incidence ofpostoperative pathogens infection.Laparoscopic surgery has relatively lower damage for autoimmune function,which isgood for recovery.It is worth to be popularized and applied for the treatment of rectal cancer surgery.