腹腔镜手术根治结直肠癌对机体免疫及应激的影响

Effect of Laparoscopic Radical Surgery on Colorectal Cancer and Immunity

目的探讨腹腔镜手术根治结直肠癌对机体免疫及应激的影响。方法选择结直肠癌患者146例作为研究对象,根据手术方法的不同分为观察组80例与对照组66例。对照组给予开腹手术根治治疗,观察组给予腹腔镜手术根治治疗,记录机体免疫及应激的变化。结果观察组术中出血量、术后排气时间、术后住院时间与对照组比较,差异有统计学意义(P <0. 05)。观察组术后14 d的吻合口漏、肛门失禁、盆腔出血等并发症发生率为3. 8%,低于对照组的21. 2%(P <0. 05)。观察组与对照组术后14 d的血清皮质醇含量都显著低于术后1 d,且观察组低于对照组(P <0. 05)。观察组与对照组术后14 d的CD4+高于术后1 d,CD4+CD25+值低于术后1 d,对比差异有统计学意义(P <0. 05);观察组术后14 d CD4+、CD4+CD25+与对照组比较,差异有统计学意义(P <0. 05)。结论腹腔镜手术根治结直肠癌能调节机体免疫功能,缓解应激反应,减少并发症的发生,促进患者康复。

Objective To investigate the effect of laparoscopic radical surgery on colorectal cancer and immunity.Methods 146 patients with colorectal cancer were selected as subjects.According to the different surgical methods,80 patients in the observation group and 66 patients in the control group were included.The group was given radical surgery for open surgery,and the observation group was given radical treatment with laparoscopic surgery to record changes in body immunity and stress.Results The intraoperative blood loss,postoperative exhaust time and postoperative hospital stay in the observation group were compared with the control group,and the difference was statistically significant(P<0.05).The complication rate of anastomotic leakage,anal incontinence and pelvic hemorrhage was 3.8%in the observation group at 14 days,after surgery,which was lower than 21.2%in the control group(P<0.05).The serum cortisol levels in the observation group and the control group were significantly lower than those in the control group at 14 days after operation.The observation group was lower than the control group(P<0.05).The CD4+of the observation group and the control group was higher than that of the control group for 14 days,and the CD4+CD25+value was lower than that of the control group for 1 day.The difference was statistically significant(P<0.05).The CD4+、CD4+CD25+in the observation group at 14 days,after surgery were compared with the control group,and the difference was statistically significant(P<0.05).Conclusion Laparoscopic surgery for colorectal cancer can regulate the body’s immune function,relieve stress response,reduce the occurrence of complications,and promote the recovery of patients.