双镜联合术和开腹手术治疗大肠癌的疗效及对机体免疫功能的影响

The Efficacy of Double-mirror Combined with Open Surgery for Colorectal Cancer and Its Effect on Immune Function

目的研究双镜联合术和开腹手术治疗大肠癌的疗效及对机体免疫功能的影响。方法方便选取2015年1月—2018年6月于该院收治的大肠癌患者90例,按治疗方案的不同随机将其分为对照组和研究组,各45例。对照组行开腹手术治疗,研究组行双镜联合术治疗。比较两组患者手术情况,同时比较两组手术前后免疫功能指标的变化。结果研究组手术时间、术中出血量及住院时间数值[(160.93±50.03)min,(186.97±81.07)mL,(15.61±1.15)d]均显著低于对照组[(196.34±67.21)min,(231.23±66.99)mL,(16.46±1.21)d(t=2.84、2.82、3.42,P<0.05)];术后,研究组血清CD3+、CD4+、CD8+水平[术后1 d:(49.14±8.15)%,(31.48±5.13)%,(25.08±4.03)%;术后7 d:(62.87±9.52)%,(40.33±5.76)%,(30.55±4.55)%]明显高于对照组[术后1 d:(43.20±7.29)%,(28.22±4.57)%,(22.73±3.52)%;术后7 d:(55.75±8.28)%,(35.76±5.27)%,(27.86±3.51)%(t=3.64、3.18、2.95,P<0.05;t=3.79、3.93、3.14,P<0.05)];两组术后血清IgA、IgG水平比较差异无统计学意义(P>0.05),而IgM水平[术后1 d:(165.36±25.70)IU/mL;术后7 d:(176.85±26.44)IU/mL]明显高于对照组[术后1 d:(150.09±25.07)IU/mL;术后7 d:(160.03±25.81)IU/mL(t=2.85,P<0.05;t=3.05,P<0.05)]。结论相较于传统开腹手术而言,双镜联合术治疗大肠癌可以在保证手术效果的同时,对机体免疫抑制程度较轻。

Objective To study the efficacy of double-mirror combined with open surgery in the treatment of colorectal cancer and its effect on immune function.Methods A total of 90 patients with colorectal cancer admitted to the hospital from January 2015 to June 2018 were convenient selected and randomly divided into the control group and the study group,45 cases each.The control group underwent open surgery and the study group underwent double-mirror surgery.The operation of the two groups was compared,and the changes of immune function indexes before and after surgery were compared.Results The operation time,intraoperative blood loss and hospitalization time of the study group[(160.93±50.03)min,(186.97±81.07)mL,(15.61±1.15)d]were significantly lower than the control group[(196.34±67.21)min,(231.23±66.99)mL,(16.46±1.21)d(t=2.84,2.82,3.42,P<0.05)];postoperative,serum CD3+,CD4+,CD8+levels in the study group[1 d after surgery:(49.14±8.15)%,(31.48±5.13)%,(25.08±4.03)%;postoperative 7 d:(62.87±9.52)%,(40.33±5.76)%,(30.55±4.55)%]significantly higher than the control group[postoperative 1 d:(43.20±7.29)%,(28.22±4.57)%,(22.73±3.52)%;7 d after surgery:(55.75±8.28)%,(35.76±5.27)%,(27.86±3.51)%(t=3.64,3.18,2.95,P<0.05;t=3.79,3.93,3.14,P<0.05)];There was no significant difference in serum IgA and IgG levels between the two groups(P>0.05),while IgM levels.[1 d after operation:(165.36±25.70)IU/mL;7 d after operation:(176.85±26.44)IU/mL]was significantly higher than the control group[1 d after surgery:(150.09±25.07)IU/mL;After 7 d:(160.03±25.81)IU/mL(t=2.85,P<0.05;t=3.05,P<0.05)].Conclusion Compared with traditional open surgery,double-mirror combined with surgery for colorectal cancer can ensure the surgical effect and the degree of immune suppression to the body is lighter.