腹腔镜与开腹根治术对进展期胃癌患者的近期疗效、应激水平、免疫功能影响的差异性研究(1)
摘 要：目的 探討腹腔镜与开腹根治术对进展期胃癌患者的近期疗效、应激水平、免疫功能影响的差异。方法 收集2015年1月～2017年10月我院收治的行腹腔镜或开腹根治性切除术的141例胃癌患者临床资料。根据手术方式的不同，将患者分为腹腔镜组79例，开腹组62例。从近期疗效、应激水平相关指标、免疫功能指标、肿瘤微转移指标等方面比较两种手术方式的差异。结果 ①与开腹组相比，腹腔镜组患者术中失血量较少，术后排气时间及住院时间较短，但住院费用较高，差异有统计学意义(P<0.05)。但两组患者的术后并发症发生率及并发症类型差异无统计学意义(P>0.05)。②两组患者WBC计数、外周血N%在所有时间点差异均无统计学意义(P>0.05)。腹腔镜组外周血CRP水平、COR水平在术后1 d、术后3 d两个时间均小于开腹组，差异有统计学意义(P<0.05)。与开腹组相比，腹腔镜组腹引液IL-6水平在术后所有时间点均较小，差异有统计学意义(P<0.05)。③两组患者外周血IgG、IgA、IgM、C4水平在所有时间点差异均无统计学意义(P>0.05)。与开腹组相比，腹腔镜组患者外周血C4水平在术后1 d、术后3 d较高，差异有统计学意义(P<0.05)，其他时间点两组患者C4水平差异无统计学意义(P>0.05)。腹腔镜组患者腹引液IL-10水平在术后所有时间点均高于开腹组，差异有统计学意义(P<0.05)。④手术结束时，腹腔镜组腹腔冲洗液CEA水平、DDC水平均小于开腹组，差异具有统计学意义(P<0.05)。结论 对于进展期胃癌，与开腹手术相比，腹腔镜治疗具有术后恢复快、应激创伤小、免疫抑制功能低、肿瘤微转移几率小等优点。
, 百拇医药
关键词：胃肿瘤；进展期胃癌；免疫功能；肿瘤微转移
中图分类号：R735.2 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.14.022
文章编号：1006-1959(2018)14-0075-06
Abstract：Objective To investigate the effects of laparoscopic and open radical resection on the short-term efficacy，stress level and immune function of patients with advanced gastric cancer.Methods The clinical data of 141 patients with gastric cancer who underwent laparoscopic or open radical resection from January 2015 to October 2017 were collected.According to the different surgical methods，the patients were divided into laparoscopic group(n=79)and open group(n=62).The differences between the two surgical methods were compared in terms of short-term efficacy，stress-related indicators，immune function indicators，and tumor micrometastasis indicators.Results ①Compared with the open group， the laparoscopic group had less blood loss during operation，and the postoperative exhaust time and hospitalization time were shorter，but the hospitalization cost was higher，and the difference was statistically significant(P<0.05).However，there was no significant difference in postoperative complication rate and type of complications between the two groups(P>0.05).②There were no significant differences in WBC count and peripheral blood N% between the two groups at all time points (P>0.05). The CRP level and COR level in the peripheral blood of the laparoscopic group were lower than those in the open group at 1 d and 3 d after operation，the difference was statistically significant(P<0.05).Compared with the open group， the level of IL-6 in the laparoscopic group was small at all time points after operation，and the difference was statistically significant (P<0.05).③The levels of IgG，IgA，IgM and C4 in peripheral blood of the two groups were not statistically significant at all time points(P>0.05).Compared with the open group，the C4 level in peripheral blood of patients in the laparoscopic group was higher at 1 d and 3 d after operation，the difference was statistically significant(P<0.05).At other time points，there was no significant difference in C4 levels between the two groups(P>0.05).In the laparoscopic group，IL-10 levels in the abdominal drainage were higher than those in the open group at all time points after surgery，the difference was statistically significant (P<0.05).④ At the end of the operation，the CEA level and DDC level of the peritoneal washing fluid in the laparoscopic group were lower than those in the open group，and the difference was statistically significant(P<0.05).Conclusion For advanced gastric cancer，compared with open surgery，laparoscopic treatment has the advantages of rapid postoperative recovery，low stress trauma，low immunosuppressive function，and small micrometastasis., 百拇医药(肖宝强 张霆 孙新增 石磊 牛悦)
, 百拇医药
关键词：胃肿瘤；进展期胃癌；免疫功能；肿瘤微转移
中图分类号：R735.2 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.14.022
文章编号：1006-1959(2018)14-0075-06
Abstract：Objective To investigate the effects of laparoscopic and open radical resection on the short-term efficacy，stress level and immune function of patients with advanced gastric cancer.Methods The clinical data of 141 patients with gastric cancer who underwent laparoscopic or open radical resection from January 2015 to October 2017 were collected.According to the different surgical methods，the patients were divided into laparoscopic group(n=79)and open group(n=62).The differences between the two surgical methods were compared in terms of short-term efficacy，stress-related indicators，immune function indicators，and tumor micrometastasis indicators.Results ①Compared with the open group， the laparoscopic group had less blood loss during operation，and the postoperative exhaust time and hospitalization time were shorter，but the hospitalization cost was higher，and the difference was statistically significant(P<0.05).However，there was no significant difference in postoperative complication rate and type of complications between the two groups(P>0.05).②There were no significant differences in WBC count and peripheral blood N% between the two groups at all time points (P>0.05). The CRP level and COR level in the peripheral blood of the laparoscopic group were lower than those in the open group at 1 d and 3 d after operation，the difference was statistically significant(P<0.05).Compared with the open group， the level of IL-6 in the laparoscopic group was small at all time points after operation，and the difference was statistically significant (P<0.05).③The levels of IgG，IgA，IgM and C4 in peripheral blood of the two groups were not statistically significant at all time points(P>0.05).Compared with the open group，the C4 level in peripheral blood of patients in the laparoscopic group was higher at 1 d and 3 d after operation，the difference was statistically significant(P<0.05).At other time points，there was no significant difference in C4 levels between the two groups(P>0.05).In the laparoscopic group，IL-10 levels in the abdominal drainage were higher than those in the open group at all time points after surgery，the difference was statistically significant (P<0.05).④ At the end of the operation，the CEA level and DDC level of the peritoneal washing fluid in the laparoscopic group were lower than those in the open group，and the difference was statistically significant(P<0.05).Conclusion For advanced gastric cancer，compared with open surgery，laparoscopic treatment has the advantages of rapid postoperative recovery，low stress trauma，low immunosuppressive function，and small micrometastasis., 百拇医药(肖宝强 张霆 孙新增 石磊 牛悦)