结肠癌根治术后早期应用吲哚美辛对患者免疫功能、凝血状态及术后恢复的影响

Effect of early application of indomethacin on immune function,coagulation status and recovery of patients with colon cancer after radical resection

目的评价结肠癌根治术后早期应用吲哚美辛对患者免疫功能、凝血状态和术后恢复的影响。方法选取2018年1月至2019年6月于胃肠外科接受结肠癌根治性切除手术患者53例,随机分为观察组和对照组。所有的根治术均在全麻下腹腔镜中进行。术后均予常规处理,观察组加用吲哚美辛栓100 mg,纳肛,连用1周。流式细胞仪检测患者外周血T细胞亚群;血栓弹力图描记术前、术后1 d和7 d凝血状态;比较2组术后并发症、术后出血时间、恢复早期活动时间及住院时间。结果2组患者均未观察到围术期严重并发症,观察组术后排气时间和首次下床活动时间均早于对照组(P<0.05)。2组患者术前CD4^+T细胞表达率、CD4^+/CD8^+比值、NK细胞活性差异无统计学意义(P>0.05);术后第7天观察组患者上述免疫指标均高于对照组(P<0.05)。术前2组患者血栓弹力图指标反应时间(R)、最大切角(α-Angle)和最大振幅(MA)差异无统计学意义(P>0.05);术后第7天观察组患者R值升高、α-Angle及MA缩小,与对照组同期比较差异有统计学意义(P<0.05)。结论吲哚美辛早期应用可改善结肠癌患者术后免疫功能及凝血状态,促进术后恢复。

AIM To evaluate the effect of early application of indomethacin on immune function,coagulation status and recovery of patients after radical resection of colon cancer.METHODS From January 2018 to January 2019,53 patients with colon cancer were randomly divided into observation group and control group.All the radical operations were performed laparoscopically under general anesthesia.The observation group was given conventional treatment combined with indomethacin suppository at the dosage of 100 mg per day for continuous medi-cation 7 d.Flow cytometry was used to detect the T cell subsets and thromboclastography was used to measure the coagulation of colon cancer patients at preoperation,1 d and 7 d postoperation.Postoperative complications,the time for passage of flatus,time to resume early activity and that of hospital stay were also compared between 2 groups.RESULTS No serious complications were observed in 2 groups.The postoperative exhaust time and time to get out of bed for activity for the first time of the observation group were shorter than those of the control group(P<0.05).There was no significant difference in levels of CD4^+,CD4^+/CD8^+and NK in peripheral blood between 2 groups before operation(P>0.05).Seven days after operation,the above immune indexes of the observation group were significantly elevated than those of the control group(P<0.05).There was no significant difference in reaction time(R),α-Angle and mazimum amplitude(MA)between 2 groups before operation(P>0.05).Seven days postoperation,theα-Angle and MA of the study group were significantly declined,while R was promoted,which were significantly different from those of the control group(P<0.05).CONCLUSION Early application of indomethacin can improve the immune function and coagulation status of patients with colon cancer,and promote postoperative recovery.