腔镜辅助近端胃癌根治术对近端胃癌患者NK细胞以及T淋巴细胞的影响

Effect of Endoscopic Assisted Radical Gastrectomy on NK Cells and T Lymphocytes

目的探讨对胃癌患者实施腔镜辅助近端胃癌根治术的临床效果,评估治疗后患者NK细胞、T淋巴细胞的变化情况。方法选择2017年4月~2019年4月我院收治的近端胃癌患者94例,随机分为实验组和对照组,各47例。对照组行开腹手术治疗,实验组行腔镜辅助近端胃癌根治术治疗,比较两组术中出血量、手术时间、术后首次下床时间、首次进食时间、首次排气时间、住院时间、NK细胞及T淋巴细胞水平。结果两组手术时间比较,差异无统计学意义(P>0.05);实验组术中出血量、首次下床、首次进食、首次排气及住院时间均少于对照组,差异有统计学意义(P<0.05)。治疗1月后,实验组CD8+、CD3+、CD4+、CD4+/CD8+水平、NK细胞水平分别为(23.06±1.11)%、(62.86±4.85)%、(62.86±4.85)%、(1.15±0.18)%、(38.62±3.62)%,均优于对照组的(28.26±1.54)%、(56.05±3.99)%、(24.26±2.05)%、(0.95±0.11)%、(28.26±1.84)%,差异有统计学意义(P<0.05)。结论腔镜辅助近端胃癌根治术可有效减少术中出血量,缩短患者术后恢复时间,增强其NK细胞以及T淋巴细胞水平,值得应用。

Objective To explore the clinical effect of endoscopic assisted radical gastrectomy for gastric cancer patients,and to evaluate the changes of NK cells and T lymphocytes in patients after treatment.Methods From April 2017 to April 2019,94 patients with proximal gastric cancer admitted to our hospital were randomly divided into experimental group and control group,with 47 cases in each group.Patients in the control group underwent laparotomy,the experimental group underwent endoscopic assisted radical gastrectomy for proximal gastric cancer,the intraoperative blood loss,operation time,first time to get out of bed,first time to eat,first time to exhaust,hospitalization time,NK cell and T lymphocyte levels were compared between the two groups.Results The difference in operation time between the two groups was not statistically significant(P>0.05);the intraoperative blood loss,the first time out of bed,the first meal,the first exhaust and the hospitalization time of the experimental group were less than the control group,the difference was statistically significant(P<0.05).After 1 month of treatment,the levels of CD8+,CD3+,CD4+,CD4+/CD8+and NK cell activity in the experimental group were(23.06±1.11)%,(62.86±4.85)%,(62.86±4.85)%,(1.15±0.18)%,(38.62±3.62)%,better than the control group(28.26±1.54)%,(56.05±3.99)%,(24.26±2.05)%,(0.95±0.11)%,(28.26±1.84)%,the difference was statistically significant(P<0.05).Conclusion Endoscopic assisted radical gastrectomy for proximal gastric cancer can effectively reduce the amount of intraoperative bleeding,shorten the recovery time of patients after surgery,and enhance the activity of NK cells and T lymphocytes.