腹腔镜胃癌根治术对早期胃癌患者免疫功能的影响

Laparoscopic-assisted radical gastrectomy for early gastric cancer and its effect on immune function

目的:探讨腹腔镜胃癌根治术对早期胃癌患者免疫功能的影响。方法:选取2016年1月-2019年1月在我院接受治疗的早期胃癌患者100例,根据手术方式不同分为观察组和对照组,对照组(44例)行传统开腹远端胃癌根治术,观察组(56例)行腹腔镜胃癌根治术。比较两组患者手术指标情况,记录手术前后超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、血清肿瘤坏死因子-α(TNF-α)及免疫功能CD3^+、CD4^+、CD8^+、CD4^+/CD8^+变化,统计治疗期间并发症发生情况。结果:观察组切口长度、住院时间短于对照组,术中出血量低于对照组(P<0.05);两组患者手术时间、淋巴结清扫数目比较差异无统计学意义(P>0.05)。术后两组患者hs-CRP、IL-6、TNF-α均有升高,但观察组上述指标低于对照组(P<0.05);两组患者CD3^+、CD4^+、CD8^+免疫功能指标均有降低,但观察组高于对照组(P<0.05);两组患者CD4^+/CD8^+比值均升高,且观察组高于对照组(P<0.05)。治疗期间观察组并发症总发生率低于对照组(7.14%vs 25.00%,P<0.05)。结论:腹腔镜胃癌根治术治疗早期胃癌效果显著,可有效降低机体应激反应,减少免疫功能损伤,降低术后并发症发生率。

Objective:To investigate the clinical effect of laparoscopic-assisted radical gastrectomy for early gastric cancer and its influence on immune function,so as to provide reference for clinical treatment.Methods:A total of 100 patients with early gastric cancer who were treated in our hospital from January 2016 to January 2019 were selected.They were divided into observation group and control group according to different surgical methods.The control group(44 cases)underwent traditional laparotomy and distal gastric cancer radical resection.Group(56 cases)underwent laparoscopic radical gastrectomy.Compare the surgical indicators of the two groups of patients,record high-sensitivity C-reactive protein(hs-CRP),interleukin-6(IL-6),serum tumor necrosis factor-α(TNF-α)and immune function CD3^+,CD4^+before and after surgery,CD8^+,CD4^+/CD8^+changes,statistics of complications during treatment.Results:The incision length and hospitalization time of the observation group were shorter than those of the control group,and the amount of bleeding during operation was lower than that of the control group(P<0.05);the operation time and the number of lymph node dissection of the two groups were compared(P>0.05).Postoperatively,hs-CRP,IL-6 and TNF-alpha increased in both groups,but the above indexes in the observation group were lower than those in the control group(P<0.05).After operation,the indexes of CD3^+,CD4^+,CD8^+immune function in both groups were decreased,but those in the observation group were higher than those in the control group(P<0.05);after operation,the changes of CD4^+/CD8^+in both groups were increased,and those in the observation group were higher than those in the control group(P<0.05).During the treatment period,anastomotic leakage,pulmonary infection,respiratory failure,incision infection and other complications occurred in both groups.The total incidence of complications in the observation group during treatment was lower than that in the control group(7.14%vs 25.00%,P<0.05).Conclusion:Laparoscopic-assisted radical gastrectomy is effective in the treatment of early gastric cancer,which can effectively reduce the body's stress response,reduce immune function damage,and reduce the incidence of postoperative complications.It is worthy of clinical application.