Objective To analyze and compare the effects of laparoscopic and open radical resection for rectal cancer on autonomic nerve function and immune system of patients .Methods One hundred patients with rectal cancer who were admitted and treated in our hospital from March 2014 to March 2016 were enrolled in the study .These patients were divided into observation group ( n =54 ) and control group ( n =46 ) according to different surgical modes .The patients in observation group were treated by laparoscopic surgery for reserving pelvic autonomic nerves ,however,the patients in control group were treated by open surgery for reserving pelvic autonomic nerves .The operation conditions , immunological indexes before and after surgery , erection and ejaculatio function in male patients , postoperative pain status and sexual pleasure in female patients were observed and compared between two groups .Results There were no significant differences in the operation time and incidence rate of postoperative complicatins between two groups ( P >0.05 ).The intraoperative hemorrhage volume in observation group was significantly less than that in control group , moreover , the recovery time of intestinal tract function and the length of staying in hospital after surgery in observation group were significantly shorter than those in control group ( P <0.05).There were significant differences in the serum levels of CRP and IL-6 on 1d,3d after operation between two groups ( P <0.05).However there were no significant differences in the levels of CD 4 +,CD8 +, NK cells, CD4 +/CD8 +ratio on 1d,3d after operation between two groups ( P >0.05).The recovery of erection and ejaculatio function in male patients in observation group was superior to that in control group ( P <0.05 ) .The incidence rate of postoperative pain during sex life in female patients in observation group was lower than that in control group ( P <0.05), moreover , the sexual pleasure status after operation in female patients in observation group was superior to that in control group ( P <0.05).Conclusion As compared with open surgery,the laparoscopic surgery for rectal cancer has a certain protective effects on immunological function , moreover , the effects of laparoscopic surgery on erection and ejaculatio function in male patients are less than those of open surgery ,besides , which can decrease the incidence rate of postoperative pain during sex life in female patients , and the recovery status of sexual pleasure is better than that of open surgery .%目的 比较腹腔镜与开腹直肠癌根治术对自主神经功能及免疫系统的影响.方法 选取收治的确诊为直肠癌需行手术治疗患者100例,按照手术方式不同分为观察组(54例)和对照组(46例).观察组为腹腔镜下保留盆腔自主神经,对照组为开腹保留盆腔自主神经;比较2组患者的手术情况.手术前后的免疫指标;术后男性患者勃起功能和射精功能的情况,术后女性患者性生活时出现疼痛的情况及获得性快感的情况.结果 2组患者在手术时间和术后并发症的发生情况的差异无统计学意义(P>0.05);观察组的术中出血量明显较对照组少,肠道功能恢复时间和术后住院时间观察组也明显少于对照组,差异有统计学意义(P<0.05).观察组与对照组的CRP、IL-6在术后第1天及术后第3天的差异有统计学意义(P<0.05);观察组与对照组的CD4+、CD8+、NK细胞及CD4+/CD8+在术后第1天及术后第3天间差异无统计学意义(P>0.05).观察组男性患者术后勃起功能和射精功能恢复较对照组好,差异有统计学意义(P<0.05).观察组中女性患者术后性生活中出现疼痛较对照组少;差异有统计学意义(P<0.05).观察组中女性患者术后获得性快感的情况较对照组好,差异有统计学意义(P<0.05).结论 直肠癌腹腔镜手术较开腹手术来说,在一定程度上对患者提供一定的免疫保护;腹腔镜手术术后对男性患者勃起功能、射精功能的影响较开腹手术小,减少了术后女性患者性生活时发生疼痛的几率,并且获得性快感的恢复情况也比开腹手术要好.
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