腹腔镜联合结肠镜根治术对结肠癌患者免疫功能及术后并发症的影响

Effect of laparoscopy combined with colonoscopy radical resection of colon cancer on immune function and postoperative complication

目的 探讨腹腔镜联合结肠镜根治术对结肠癌患者免疫功能及术后并发症的影响。方法 根据手术方式的不同将75例结肠癌患者分为对照组(n=37)和观察组(n=38),对照组患者予以传统开腹手术,观察组患者予以腹腔镜联合结肠镜结肠癌根治术。比较两组患者手术相关指标、免疫功能[辅助性T细胞(Th)1和Th2水平,并计算Th1/Th2]、炎症因子[肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-6、IL-10]及并发症发生情况。结果观察组患者手术时间、术后住院时间、术后排气时间均短于对照组,术中出血量少于对照组,术后镇痛率低于对照组,差异均有统计学意义(P﹤0.05)。术后5天,两组患者Th1水平和Th1/Th2均低于本组术前,Th2水平均高于本组术前,观察组患者Th1水平和Th1/Th2均高于对照组,Th2水平低于对照组,差异均有统计学意义(P﹤0.05)。术后5天,两组患者TNF-α、IL-6、IL-10水平均低于本组术前,观察组患者TNF-α、IL-6、IL-10水平均低于对照组,差异均有统计学意义(P﹤0.05)。观察组患者术后并发症总发生率为5.26%,低于对照组患者的24.32%,差异有统计学意义(P﹤0.05)。结论 与传统开腹手术相比,腹腔镜联合结肠镜结肠癌根治术可有效改善患者手术情况,对结肠癌患者免疫系统的影响更小,可降低术后并发症发生率。

Objective To explore the effect of laparoscopy combined with colonoscopy radical resection of colon cancer on immune function and postoperative complication. Method A total of 75 patients with colon cancer were divided into control group(n=37) and observation group(n=38) according to different surgical methods. The patients in the control group received traditional laparotomy, and the patients in the observation group received laparoscopy combined with colonoscopy radical resection of colon cancer. The surgery-related indicators, immune function [helper T cell(Th)1, Th2,Th1/Th2], inflammatory factors [tumor necrosis factor-α(TNF-α), interleukin(IL)-6, IL-10] and complications were compared between the two groups. Result The operation time, postoperative hospital stay, and postoperative exhaust time of the observation group were shorter than those of the control group, the intraoperative blood loss was less than that of the control group, and the postoperative analgesic rate was lower than that of the control group, and the differences were statistically significant(P<0.05). Five days after operation, the Th1 levels and Th1/Th2 in the two groups were lower than those before operation, and the Th2 levels were higher than those before operation, the Th1 level and Th1/Th2 in the observation group were higher than those in the control group, and the Th2 level was lower than that in the control group,and the differences were statistically significant(P<0.05). Five days after the operation, the levels of TNF-α, IL-6, and IL-10 in the two groups were lower than those before the operation, and the levels of the above indicators in the observation group were lower than those in the control group, and the differences were statistically significant(P<0.05). The total incidence of postoperative complications in the observation group was 5.26%, which was lower than 24.32% in the control group, and the difference was statistically significant(P<0.05). Conclusion Compared with traditional open surgery, laparoscopy combined with colonoscopy radical resection of colon cancer can effectively improve the operation conditions of patients, have less impact on the immune system of patients with colon cancer, and reduce the incidence of postoperative complications.