腹腔镜胃癌根治术对机体炎性反应和免疫功能的影响

摘要

Objective:To investigate the effect of laparoscopic radical gastrectomy on inflammatory reaction and immune function.Method:30 patients who were treated with laparoscopic radical gastrectomy in our hospital from January 2014 to January 2015 were selected as the laparoscopic group.30 patients who were treated with open radical gastrectomy were selected as the control group at the same time.The changes of CD4+/CD8+,CD8+,CD4+,TNF-α and IL-6 in the two groups were compared before and after operation.Result:Before operation,the differences in levels of TNF-α and IL-6 were not statistically significant(P>0.05).The second days after operation,the levels of TNF-α and IL-6 in the two groups were all higher than those before operation,the levels of TNF-α and IL-6 in the control group were higher than those in the observation group,the differences were statistically significant(P<0.05).The first day after operation,the levels of CD4+/CD8+ and CD4+ in the two groups were all lower than those before operation,the differences were statistically significant(P<0.05),but the differences between the two groups were not statistically significant(P>0.05). The first and seventh day after operation,the differences in the levels of CD8+ between the two groups were not statistically significant(P>0.05).The seventh day after operation,the levels of CD4+ and CD4+/CD8+ in the control group were lower than those before operation and the first day after operation,they were also lower than those in the observation group,the differences were all statistically significant(P<0.05).But the differences in levels of CD4+ and CD4+/CD8+ that before operation and that the seventh day after operation were not statistically significant(P>0.05).Conclusion:Laparoscopic gastric carcinoma has the advantages of small trauma,small effect on the whole body inflammatory reaction and immune function.It can protect the immune function of patients better than open operation.%目的：探讨腹腔镜胃癌根治术对机体炎性反应和免疫功能的影响。方法：选择2014年1月-2015年1月于本院接受腹腔镜胃癌根治术患者30例作为腹腔镜组，对照组30例为同期行开腹胃癌根治术患者，比较两组手术前后TNF-α、IL-6水平以及两组手术前后CD4+、CD8+，CD4+/CD8+的变化。结果：两组术前TNF-α、IL-6水平比较差异无统计学意义（P>0.05），术后第2天，两组TNF-α、IL-6水平均高于术前，对照组TNF-α、IL-6水平高于腹腔镜组，比较差异均有统计学意义（P<0.05）；术后第1天，两组CD4+、CD4+/CD8+水平低于术前，比较差异有统计学意义（P<0.05），但两组间比较差异无统计学意义（P>0.05）；两组术后第1天、第7天的CD8+水平比较差异无统计学意义（P>0.05）。术后第7天，对照组CD4+、CD4+/CD8+水平低于术前及术后第1天，比较差异有统计学意义（P<0.05）；但观察组术后第7天CD4+、CD4+/CD8+水平与术前比较，差异无统计学意义（P>0.05）；观察组术后第7天的CD4+、CD4+/CD8+水平高于对照组，比较差异有统计学意义（P<0.05）。结论：腹腔镜胃癌根治术创伤小，对全身炎性反应及免疫功能影响小，较开腹手术能更好地保护患者的免疫功能。