术后腹腔热灌注化疗对结直肠癌患者胃肠功能、免疫功能及炎性因子的影响

Effect of postoperative hyperthermic intraperitoneal chemotherapy on gastrointestinal function,immune function,and inflammatory factors in patients with colorectal cancer

目的探讨术后腹腔热灌注化疗对结直肠癌患者胃肠功能、免疫功能及炎性因子的影响。方法根据术后化疗方法的不同将108例腹腔镜结直肠癌根治术患者分为对照组和观察组,每组54例,对照组患者采用静脉化疗,观察组患者采用腹腔热灌注化疗。比较两组患者的胃肠功能指标[胃动素(MTL)、胃泌素(GAS)]、免疫功能指标(CD4+、CD8+水平及CD4+/CD8+)、炎性因子[C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]水平及不良反应发生情况。结果化疗后,两组患者的MTL、GAS水平均低于本组化疗前,观察组患者的MTL、GAS水平均高于对照组,差异均有统计学意义(P﹤0.05)。化疗后,两组患者的CD4+水平及CD4+/CD8+均高于本组化疗前,CD8+水平均低于本组化疗前,观察组患者的CD4+水平及CD4+/CD8+均高于对照组,差异均有统计学意义(P﹤0.05)。化疗后,两组患者的CRP、IL-6、TNF-α水平均低于本组化疗前,观察组患者的CRP、IL-6、TNF-α水平均低于对照组,差异均有统计学意义(P﹤0.05)。两组患者的不良反应总发生率比较,差异无统计学意义(P﹥0.05)。结论术后腹腔热灌注化疗可改善结直肠癌患者的胃肠功能和免疫功能,降低炎性因子水平,且具有一定的安全性。

Objective To investigate the effect of postoperative hyperthermic intraperitoneal chemotherapy on gastrointestinal function,immune function,and inflammatory factors in patients with colorectal cancer.Method A total of 108 patients with laparoscopic radical resection of colorectal cancer were divided into control group and observation group according to different postoperative chemotherapy methods,with 54 cases in each group.The patients in the control group received intravenous chemotherapy,and the patients in the observation group received hyperthermic intraperitoneal chemotherapy.The gastrointestinal function indicators[motilin(MTL),gastrin(GAS)],immune function indicators(CD4+,CD8+levels,and CD4+/CD8+),inflammatory factors[C-reactive protein(CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)]levels and adverse events were compared between the two groups.Result After the chemotherapy,the levels of MTL and GAS in the two groups were lower than those before the chemotherapy,and the levels of MTL and GAS in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).After the chemotherapy,the levels of CD4+and CD4+/CD8+in the two groups were higher than those before the chemotherapy,and the levels of CD8+were lower than those before the chemotherapy,the CD4+level and CD4+/CD8+in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).After the chemotherapy,the levels of CRP,IL-6,and TNF-αin the two groups were lower than those before the chemotherapy,and the levels of the foregoing factors in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).There was no significant difference in the total incidence of adverse events between the two groups(P>0.05).Conclusion Postoperative hyperthermic intraperitoneal chemotherapy could improve the gastrointestinal function and immune function of patients with colorectal cancer,and reduce the level of inflammatory factors with acceptable safety.