高压氧辅助治疗对胃癌根治术后患者胃肠激素及免疫因子的影响

Effect of hyperbaric oxygen therapy on gastrointestinal hormones and immune factors in patients with gastric cancer after laparoscopic radical gastrectomy

目的探讨腹腔镜根治术后应用高压氧(HBO)治疗对胃癌患者胃肠激素及免疫功能的影响。方法选择2018年5月至2019年12月山西省长治医学院附属和平医院收治的82例腹腔镜胃癌根治术患者,采用随机数字表法分为观察组及对照组,每组41例。2组患者均行腹腔镜胃癌根治术,观察组术后行HBO治疗。比较2组患者手术时间、术中出血量、排气时间及住院时间;比较2组患者术前1 d、术后第6天血清胃肠激素(胃动素、胃泌素)及T淋巴细胞亚群(CD3+、CD4+、CD8+、CD4+/CD8+)水平。结果观察组患者术后排气时间及住院时间均短于对照组,差异均有统计学意义(P<0.05);2组患者术后第6天血清胃动素、胃泌素水平较术前1 d明显降低,且观察组治疗后胃动素、胃泌素水平高于对照组,差异均有统计学意义(P<0.05或P<0.01);术后第6天,2组患者血清CD3+、CD4+、CD4+/CD8+水平较术前1 d明显下降,CD8+水平较术前1 d明显升高,且观察组治疗后CD3+、CD4+、CD4+/CD8+水平高于对照组(P<0.05),但2组患者术后第6天CD8+水平比较差异无统计学意义(P>0.05)。结论腹腔镜胃癌根治术后采用HBO治疗,可缩短患者术后排气时间与住院时间,促进术后胃肠激素的分泌与免疫功能的恢复。

Objective To observe the effect of hyperbaric oxygen therapy on gastrointestinal hormones and immune factors in patients with gastric cancer after laparoscopic radical gastrectomy.Methods A total of 82 patients received laparoscopic radical gastrectomy in the Heping Hospital Affiliated to Changzhi Medical College of Shanxi Province from May 2018 to December 2019 were selected and divided into observation group and control group by the random number table method,with 41 cases in each group.After laparoscopic radical gastrectomy,only the observation group received hyperbaric oxygen therapy.The operation time,intraoperative blood loss,exhaust time,and hospital stay of the two groups were compared.The levels of gastrointestinal hormones(motilin,gastrin)and T lymphocyte subsets(CD3+,CD4+,CD8+,CD4+/CD8+)on the last day before and the third day after operation were compared between the two groups.Results The exhaust time and hospital stay of the observation group were shorter than those of the control group,and there was statistically significant difference(P<0.05);the levels of motilin and gastrin of both two groups decreased on the sixth day after operation when compared with those on the last day before operation.Moreover,the levels of motilin and gastrin of the observation group were higher than those of the control group,and there was statistically significant difference(P<0.05,or P<0.01).On the 6th day after operation,the levels of CD3+,CD4+,CD4+/CD8+of the two groups decreased when compared with those on the last day before operation,while the CD8+increased significantly.And the levels of CD3+,CD4+,CD8+,CD4+/CD8+in the observation group were higher than those in the control group,and there was statistically significant difference(P<0.05).However,there was no statistically significant difference(P>0.05)in terms of the levels of CD8+of the two groups on the sixth day after the operation.Conclusion Hyperbaric oxygen therapy on patients with gastric cancer after laparoscopic radical gastrectomy can shorten postoperative exhaust time and hospital stay,and can effectively promote the secretion of gastrointestinal hormones and the recovery of immune function after operation.