腹腔镜和开腹手术对早期胃癌术后免疫功能及近期生活质量的影响

Effect of Laparoscopic and Open Surgery on Postoperative Immune Function and Short-term Quality of Life in Early Gastric Cancer

目的分析探讨腹腔镜和开腹手术对早期胃癌术后免疫功能及近期生活质量的影响。方法方便选取该院2014年1月-2018年1月收治的44例早期胃癌患者作为研究对象,随机分为对照组和观察组各22例,对照组患者进行开腹式胃癌根治术,观察组患者采用腹腔镜胃癌根治术治疗,比较两组患者术后免疫功能和近期的生活质量。结果两组患者术前IgG、IgM、CD4-、CD4+/CD8+比较差异无统计学意义(P>0.05),观察组术后7 d IgG (12.35±1.33)g/L、IgM(1.51±0.61)g/L、CD4-(1.62±0.26)%、CD4+/CD8+(38.40±5.73)明显高于对照组术后7 d IgG (9.78±1.25)g/L、IgM (1.10±0.24)g/L、CD4-(1.23±0.21)%、CD4+/CD8+(24.35±3.37),差异有统计学意义(P<0.05);观察组患者术后心理功能(37.74±3.42)分、躯体功能(38.18±3.76)分、物质生活状态(28.84±3.20)分、社会功能方面评分(37.48±3.02)分明显高于对照组心理功能(32.45±3.54)分、躯体功能(33.29±3.39)分、物质生活状态(25.48±3.49)分、社会功能方面评分(35.42±3.11)分,差异有统计学意义(t=4.335、3.284、2.441、4.258,P<0.05)。结论腹腔镜胃癌根治术明显更提高了早期胃癌患者术后的免疫功能和生活质量,手术创伤小,更符合现代的医学模式要求,值得临床大力推广。

Objective To analyze the effects of laparoscopic and open surgery on postoperative immune function and recent quality of life in patients with early gastric cancer. Methods 44 patients with early gastric cancer admitted to our hospital from January 2014 to January 2018 were convenient selected and randomly divided into the control group and the observation group. The control group underwent open radical gastrectomy, and the patients in the observation group underwent laparoscopic radical gastrectomy, to compare postoperative immune function and recent quality of life in the two groups. Results There were no statistically significant differences in preoperative IgG, IgM, CD4-, CD4+/CD8+ between the two groups(P>0.05), and the IgG (12.35±1.33)g/L and IgM (1.51±0.61)g/L, CD4-(1.62±0.26)%, CD4+/CD8+(38.40±5.73) 7 d after operation in the observation group, were significantly higher than IgG (9.78±1.25)g/L, IgM(1.10±0.24)g/L, CD4-(1.23±0.21)%, CD4+/CD8+(24.35±3.37)points, 7 d after operation, the difference was statistically significant(P<0.05);postoperative psychological function (37.74±3.42)points, physical function (38.18±3.76)points, physical life status scores of (28.84±3.20)points and social function scores (37.48±3.02)points were significantly higher than those of the control group(32.45±3.54)points, physical function (33.29±3.39)points, and material life status (25.48±3.49)points, and the social function scores (35.42±3.11)points,the difference were statistically significant (t=4.335, 3.284, 2.441, 4.258, P<0.05). Conclusion Laparoscopic radical gastrectomy significantly improves the postoperative immune function and quality of life of patients with early gastric cancer. The surgical trauma is small and more in line with the requirements of modern medical models. It is worthy of clinical promotion.