后腹腔镜肾癌根治术治疗局限性肾癌的临床效果及其对免疫功能的影响

Clinical effect of retroperitoneal laparoscopic radical nephrectomy on localized renal cell carcinoma and its influence on immune function

目的探讨后腹腔镜手术治疗局限性肾癌的临床效果及其对患者免疫功能的影响。方法选取2013年2月至2015年11月在我院开展手术治疗的76例局限性肾癌患者作为研究对象,根据手术方式不同将其分为观察组(后腹腔镜手术)和对照组(传统手术),各38例。比较两组手术相关指标、手术前及手术24、72 h后免疫学指标(CD3^+、CD4^+、CD8^+、CD4^+/CD8^+)的变化情况。结果观察组患者术后并发症总发生率为0.00%,明显低于对照组的10.53%(P<0.05)。观察组手术出血量少于对照组,术后住院时间、手术时间、术后肠胃功能恢复时间、术后肛门排气时间均短于对照组(P<0.05)。术后24、72 h,两组患者的CD3^+、CD4^+水平均明显低于术前(P<0.05);观察组术后24、72 h的CD3+水平均明显高于对照组(P<0.05);术后72 h,观察组的CD8^+水平明显低于术前和对照组,CD4^+/CD8^+明显高于术前和对照组(P<0.05)。结论后腹腔镜手术在局限性肾癌的治疗中具有较高的安全性,利于患者术后免疫功能的恢复,有助于缩短患者住院时间,值得临床应用。

Objective To explore the clinical effect of retroperitoneal laparoscopic radical nephrectomy on localized renal cell carcinoma and its influence on immune function of patients. Methods Seventy-six patients with localized renal cell carcinoma who underwent surgical treatment in our hospital from February 2013 to November 2015 were selected as the research objects. The patients were divided into observation group(retroperitoneal laparoscopic radical nephrectomy) and control group(traditional surgery) according to the different surgical methods, with 38 cases in each group. The surgical related indicators and changes of immunological indexes(CD3^+, CD4^+, CD8^+, CD4^+/CD8^+) before and 24, 72 hours after operation were compared between the two groups. Results The total incidence of postoperative complications in the observation group was 0.00%, which was significantly lower than 10.53% in the control group(P <0.05). The amount of surgical bleeding in the observation group was less than that in the control group, and the time of hospitalization, operation,recovery of gastrointestinal function and anal exhaust after operation were shorter than those in the control group(P<0.05). At 24 and 72 hours after operation, the levels of CD3^+ and CD4^+ in the two groups were significantly lower than those before operation(P<0.05). The levels of CD3^+ in the observation group were significantly higher than those in the control group at 24 and 72 hours after operation(P<0.05). At 72 hours after operation, the level of CD8^+ in the observation group was significantly lower than that before operation and in the control group, and the CD4^+/CD8^+ in the observation group was significantly higher than that before operation and in the control group(P<0.05). Conclusion Retroperitoneal laparoscopic radical nephrectomy has high safety in the treatment of localized renal cell carcinoma. It is conducive to the recovery of immune function after operation and shortening the hospitalization time of patients, which is worthy of clinical application.