腹腔镜手术对结直肠癌根治术患者免疫功能及临床结局的影响

目的:探讨腹腔镜手术对结直肠癌根治术患者免疫功能和临床结局的影响。方法:选取我院2015年2月-2018年2月收治的50例行手术治疗的结直肠癌患者,按照数字随机原则分成两组,对照组25例采用传统开腹手术,观察组25例采用腹腔镜手术,比较两组术前、术后外周血中CD3~+、CD4~+、CD4~+/CD8~+的变化和胃肠功能的改善情况,术后随访1～3年,记录两组患者的生存情况。结果:术前,两组外周血中T淋巴细胞亚群CD3~+、CD4~+、CD4~+/CD8~+比较差异无统计学意义(P0.05);术后1周、2周,观察组CD3~+、CD4~+、CD4~+/CD8~+比例均显著高于对照组,CD8~+明显低于对照组(P0.05)。观察组术后肠鸣音恢复时间、肛门首次排气时间均显著短于对照组(P0.05),两组随访期并发症发生率、死亡率比较差异无统计学意义(P0.05)。结论:结直肠癌患者行腹腔镜手术治疗能够显著提升其免疫功能,术后胃肠功能恢复较快。

Effect of Laparoscopic Surgery on the Immune Function and Clinical Outcome of Patients Undergoing Radical Resection of Colorectal Cancer

ABSTRACT Objective: To investigate the effect of laparoscopic surgery on the immune function and clinical outcome of patients undergoing radical resection of colorectal cancer. Methods: 50 patients with colorectal cancer who underwent surgery from February 2015 to February 2018 were enrolled in the study. They were divided into two groups according to the principle of numerical randomization, and 25 patients in the control group were treated with conventional open surgery. In the observation group, 25 patients underwent laparoscopic surgery. The changes of gastrointestinal function and CD3⁺, CD4⁺, CD4⁺/CD8⁺ in the peripheral blood of the two groups were compared. The patients were followed up for 1~3 years. The survival of patients were recorded. Results: There was no significant difference in the T lymphocyte subset including CD3⁺, CD4⁺, CD4⁺/CD8⁺ in the peripheral blood between the two groups before operation (P>0.05). The CD3⁺, CD4⁺, CD4⁺/CD8⁺ in the observation group were significantly higher than those in the control group at 1 week and 2 weeks after operation, and the CD8⁺ in the observation group was significantly lower than that in the control group (P<0.05). The postoperative recovery time of bowel sound and the exhaust time of first anus in the observation group was significantly shorter than that in the control group(P<0.05). There was no statistically significant difference between the two group in the incidence of complications and mortality during the follow-up period(P>0.05). Conclusion: Laparoscopic surgery can significantly improve the immune function and promote the the recovery of ostoperative gastrointestinal functio for the patients with colorectal cancer.