胃癌根治切除术联合5-氟尿嘧啶治疗老年胃癌病人的临床疗效及对免疫功能的影响

摘要

目的探讨胃癌根治切除术联合5⁃氟尿嘧啶治疗老年胃癌病人的临床疗效及对免疫功能的影响。方法选择2012年10月至2014年6月在我院收治的老年胃癌病人120例，随机分为对照组（ n＝60）和试验组（ n＝60）。对照组病人单纯行胃癌根治切除术，试验组病人在对照组基础上给予5⁃氟尿嘧啶缓释剂治疗。观察并比较2组病人治疗后并发症发生率及不良反应发生情况。比较2组病人治疗后6月、12月及18月的生存率。检测并比较2组病人治疗前后免疫功能指标的变化。结果2组病人治疗后切口感染、吻合口瘘、腹腔脓肿、腹膜炎及肠梗阻等并发症发生率比较差异无统计学意义（ P＞0�05）。试验组病人治疗后6月、12月及18月的生存率均明显高于对照组，差异具有统计学意义（ P＜0�05）。治疗前，2组病人CD3＋、CD4＋、CD8＋及自然杀伤（ NK）细胞所占比值比较差异无统计学意义（ P＞0�05）；治疗后，试验组病人CD3＋、CD4＋、CD8＋及NK细胞所占比值明显低于治疗前，同时试验组各免疫功能指标明显低于对照组，差异具有统计学意义（ P＜0�05）。2组病人不良反应发生率比较差异无统计学意义（ P＞0�05）。结论胃癌根治切除术联合5⁃氟尿嘧啶治疗老年胃癌病人的并发症发生率较低，对病人肝、肾及骨髓等的不良反应较小，能够延长病人生存期，但对免疫功能具有一定的抑制作用。%Objective To study the clinical efficacy of radical resection for gastric carcinoma combined with 5⁃fluorouracil in the treatment for gastric cancer in the elderly and to investigate the effects on immune function. Methods A total of 120 elderly patients with gastric cancer in our hospital from October 2012 to June 2014 were enrolled in this study. The subjects were divided into control group ( n=60) and treatment group ( n=60) randomly. The control group was treated with radical resection for gastric carcinoma, while the treatment group was treated with radical resection for gastric carcinoma and 5⁃fluorouracil. The complications, adverse reactions, immune function and the survival rates 6 months, 12 months and 18 months after treatment in the two groups were compared. Results There were no significant differences in the incidence rates of complications between the two groups after treatment, such as incision infection, anastomotic fistula, abdominal abscess, peritonitis and intestinal obstruction ( P>0�05) . The survival rates 6 months, 12 months and 18 months after treatment in treatment group were significantly higher than those in control group ( P<0�05 ) . There were no significant differences in the ratios of CD3+, CD4+, CD8+and NK cells between the two groups before treatment ( P>0�05) . The ratios of CD3+, CD4+, CD8+and NK cells of the treatment group after treatment were significantly lower than those before treatment and those in control group after treatment ( P<0�05 ) . There were no significant differences in the incidence of adverse reactions between the two groups during the treatment ( P>0�05) . Conclusions Combination of radical resection for gastric carcinoma and 5⁃fluorouracil could reduce complications and prolong patient�s survival rate,with low incidence of adverse reactions on liver, kidney and bone marrow, but which shows inhibitory effects on immune function.