胸腹腔镜食管癌手术对老年食管癌患者术后细胞免疫功能的影响
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摘要
目的:观察胸腹腔镜食管癌手术对老年食管癌患者术后细胞免疫功能的影响。方法:选取88例老年食管癌患者作为研究对象,依据随机数字表法将其分为对照组与研究组各44例。对照组采用传统开放式食管癌手术,研究组采用胸腹腔镜食管癌手术。结果:研究组手术时间明显短于对照组,术中失血量明显少于对照组,差异有统计学意义(P<0.05);两组淋巴结清扫数量比较,差异无统计学意义(P>0.05);术后研究组CD4~+、CD4~+/CD8~+与NK细胞水平明显高于对照组,差异有统计学意义(P<0.05);术后两组CD8~+水平比较,差异无统计学意义(P>0.05);两组1年生存率比较,差异无统计学意义(P>0.05)。研究组并发症发生率2.27%低于对照组的15.91%,差异有统计学意义(P<0.05)。结论:胸腹腔镜食管癌手术与传统开放式食管癌手术治疗食管癌的效果相当,且其对老年食管癌患者术后细胞免疫功能的影响较小,有利于预后。
Objective: To investigate effects of thoracoscopic and laparoscopic surgery on postoperative cell immune function in elderly patients with esophageal cancer. Methods: 88 elder patients with esophageal cancer were selected as the subjects and divided into control group(n=44) and study group(n=44) by using the random number table method. The control group was given traditional open surgery, while the study group was given thoracoscopic and laparoscopic surgery. Results: The operation time of the study group was significantly shorter than that of the control group, the intraoperative blood loss was significantly less than that of the control group, and the differences were statistically significant(P<0.05). There was no significant difference in the number of lymph node dissection between the two groups(P>0.05). The levels of CD4~+, CD4~+/CD8~+and NK cells in the study group after the operation were significantly higher than those in the control group, and the differences were statistically significant(P<0.05). There was no significant difference in the CD8~+ levels between the two groups(P>0.05). There was no significant difference in 1-year survival rate between the two groups(P>0.05). The complication rate of the study group was 2.27%, which was lower than that of the control group(15.91%), and the difference was statistically significant(P<0.05). Conclusions: The thoracoscopic and laparoscopic surgery is equivalent to the traditional open surgery for esophageal cancer. Moreover, its effects on the postoperative cellular immune function in the elderly patients with esophageal cancer are less, which is beneficial to prognosis.
Objective: To investigate effects of thoracoscopic and laparoscopic surgery on postoperative cell immune function in elderly patients with esophageal cancer. Methods: 88 elder patients with esophageal cancer were selected as the subjects and divided into control group(n=44) and study group(n=44) by using the random number table method. The control group was given traditional open surgery, while the study group was given thoracoscopic and laparoscopic surgery. Results: The operation time of the study group was significantly shorter than that of the control group, the intraoperative blood loss was significantly less than that of the control group, and the differences were statistically significant(P<0.05). There was no significant difference in the number of lymph node dissection between the two groups(P>0.05). The levels of CD4~+, CD4~+/CD8~+and NK cells in the study group after the operation were significantly higher than those in the control group, and the differences were statistically significant(P<0.05). There was no significant difference in the CD8~+ levels between the two groups(P>0.05). There was no significant difference in 1-year survival rate between the two groups(P>0.05). The complication rate of the study group was 2.27%, which was lower than that of the control group(15.91%), and the difference was statistically significant(P<0.05). Conclusions: The thoracoscopic and laparoscopic surgery is equivalent to the traditional open surgery for esophageal cancer. Moreover, its effects on the postoperative cellular immune function in the elderly patients with esophageal cancer are less, which is beneficial to prognosis.
引文
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[11]王军岐,杨智,付小伟,等.胸腹腔镜联合食管癌根治术治疗老年食管癌的临床疗效及预后分析[J].现代生物医学进展,2015,15(15):2888-2890.
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[2]乔迎帅,卢锡华.胸腹腔镜联合食管癌根治术中气管破裂致心跳骤停一例[J].临床麻醉学杂志,2018,34(4):416.
[3]中国抗癌协会食管癌专业委员会.食管癌规范化诊治指南[M].北京:中国协和医科大学出版社,2011:2-3.
[4]杜大军.胸腹腔镜联合手术治疗食管癌的临床分析[J].实用肿瘤杂志,2018,33(2):170-173.
[5]梅龙勇,李小玲,吴晓丽,等.加速康复在胸段食管癌行胸腹腔镜微创手术中的应用[J].重庆医学,2018,47(7):929-932.
[6]王志远,王天宝,李奇,等.胸腹腔镜联合手术治疗食管癌的疗效及其并发症发生情况[J].实用中西医结合临床,2018,18(2):87-89.
[7]陈文树,黄郴,李武锦,等.胸腹腔镜联合食管癌根治术视频要点[J].中国胸心血管外科临床杂志,2018,25(2):113.
[8]高云飞,罗洞波,刘翼,等.胸腹腔镜对食管癌根治术患者炎症因子、肺功能及预后的影响[J].肿瘤学杂志,2018,24(1):42-46.
[9]莫靓,贺大璞,韦兵,等.全胸腹腔镜行食管癌根治术的临床应用[J].浙江医学,2017,39(24):2285-2287.
[10]傅雪颜,王浩,吴佩卿.胸腹腔镜联合行食管癌根治术36例分析[J].中国中西医结合外科杂志,2014,20(3):296-298.
[11]王军岐,杨智,付小伟,等.胸腹腔镜联合食管癌根治术治疗老年食管癌的临床疗效及预后分析[J].现代生物医学进展,2015,15(15):2888-2890.
[12]沈蔷,于国泳,邓红月,等.胸腹腔镜联合根治术治疗老年食管癌患者的临床疗效及对免疫功能的影响[J].中国医师杂志,2016,18(9):1409-1411.