进展期胃癌患者腹腔镜与开腹胃癌D2根治术前后氧化应激、T细胞及炎症因子变化比较

Changes of oxidative stress,T cells and inflammatory factors in patients with advanced gastric cancer before and after laparoscopic and open radical D2 gastrectomy

目的比较进展期胃癌患者腹腔镜与开腹胃癌D2根治术前后氧化、应激、T细胞及炎症因子变化。方法回顾性分析2016年1月至2018年12月80例进行胃癌D2根治术的患者资料,根据术式不同分为腹腔镜组和开腹组,各40例。采用SPSS19.0统计学软件分析,手术相关指标、术前术后24 h氧化应激指标、T细胞功能指标、炎症因子指标用(±s)表示,采用独立t检验;术后并发症等计数资料采用χ^2检验,P<0.05为差异有统计学意义。结果腹腔镜组患者手术时间长于开腹组,其余手术相关指标均少于开腹组(P<0.05)。术后腹腔镜组超氧化物歧化酶(SOD)水平高于开腹组,丙二醛(MDA)、8-羟基脱氧尿苷(8-OHdG)水平低于开腹组(P<0.05);术后腹腔镜组CD4+、CD3+、CD4+/CD8+均水平高于开腹组(P<0.05)。结论进展期胃癌患者腹腔镜胃癌D2根治术与开腹术相比,对患者损伤更小,患者术后免疫功能、氧化应激功能和炎症因子水平波动较小,更有利于患者术后的恢复。

Objective To compare the changes of oxidation,stress,T cells and inflammatory factors before and after laparoscopic and open gastric cancer D2 radical surgery for patients with advanced gastric cancer.Methods From January 2016 to December 2018,80 patients undergoing D2 radical resection of gastric cancer were selected as the research objects.According to different surgical procedures,they were divided into laparoscopic group and laparotomy group,each with 40 cases.SPSS19.0 statistical software was used to analyze,operation-related indexes,24 h oxidative stress and oxidative stress indexes before and after operation,T cell function indexes,and inflammatory factor indexes were expressed as,and independent t test was adopted;Count data such as complications were tested byχ^2 test,and P<0.05 was considered statistically significant.Results The operation time of the patients in the laparoscopic group was longer than that of the open group,and the other operation-related indexes were less than those in the open group(P<0.05).The level of superoxide dismutase(SOD)in the laparoscopic group was higher than that in the open group,and the levels of malondialdehyde(MDA)and 8-hydroxydeoxyuridine(8-OHdG)were lower than those in the open group(P<0.05);The levels of CD4+,CD3+,CD4+/CD8+in the laparoscopic group were higher than those in the open group(P<0.05).Conclusion Compared with laparotomy,laparoscopic gastric cancer D2 radical surgery for patients with advanced gastric cancer has less damage to the patient,and the patient's postoperative immune function,oxidative stress function and inflammatory factor.levels fluctuate less,which is more conducive to the patient's postoperative restore.