营养状况对胃癌患者微创手术效果及T淋巴细胞亚群的影响

Effects of nutritional status on minimally invasive surgery and T-lymphocyte subsets in patients with gastric cancer

目的观察营养状况对胃癌患者微创手术效果及T淋巴细胞亚群的影响。方法选取2018年1月—2020年2月安阳市第三人民医院收治的128例胃癌患者为研究对象,所有患者均采用腹腔镜辅助胃癌根治术治疗,依据患者是否存在营养风险将存在营养风险(营养风险评分≥3分)36例作为观察组,将不存在营养风险(营养风险评分<3分)92例作为对照组。比较两组患者术后免疫功能、并发症情况和住院情况。结果术后观察组患者的CD3^(+)、CD4^(+)比例及CD4^(+)/CD8^(+)比值均低于对照组患者,CD4^(+) CD25^(+)比例高于对照组患者,差异具有统计学意义(P<0.05)。两组患者CD8^(+)比例差异无统计学意义(P>0.05)。观察组和对照组患者的并发症总发生率分别为66.64%和26.02%,组间对比差异具有统计学意义(P<0.05)。术后观察组和对照组患者住院时间、费用及出院1个月内非计划性再入院率比较,差异均无统计学意义(P>0.05)。结论营养风险会降低患者术后免疫功能,增大并发症发生率,但对患者影响较小,不会延长住院时间,增多住院费用。

Objective To explore the effect of nutritional status on minimally invasive surgery in patients with gastric cancer.Methods Totally 128 patients with gastric cancer admitted in our hospital from January 2018 to February 2020 were enrolled in this study. All patients underwent laparoscopic assisted radical gastrectomy. The patients were divided into observation group and control group according to their nutritional risk. Group, and 36 patients in the observation group had nutritional risk(nutritional risk score≥3). There were no nutritional risk(nutritional risk score <3) in 92 patients in the control group. The postoperative immune function, complication and hospitalization were compared between the two groups.Results The ratio of CD3^(+), CD4^(+) and CD4^(+)/CD8^(+) in the postoperative group was lower than that of the control group, and the percentage of CD4^(+) CD25^(+) was higher than that of the control group(P<0.05). There was no significant difference in CD8^(+) ratio between the two groups(P>0.05). The overall incidence of complications in the observation group and the control group was 66.64% and 26.02% respectively. The overall incidence of complications in the observation group was significantly higher than that of the control group(P<0.05). There was no significant difference in the hospitalization time, cost and non-planned re-admission rate in the postoperative observation group and the control group(P>0.05).Conclusion Nutritional risk will reduce the postoperative immune function and increase the incidence of complications, but the impact on patients is small, will not extend the hospital stay, increase the cost of hospitalization.