腹腔镜胃癌根治术对早期胃癌患者的治疗效果及免疫水平的影响
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摘要
目的:研究分析腹腔镜胃癌根治术治疗早期胃癌患者的临床治疗效果及对免疫水平的影响。方法:选取某院2014年3月~2017年8月间治疗的60例胃癌患者,根据手术方式不同分为腹腔镜组和开腹组,每组30例,两组患者分别采用腹腔镜手术治疗和开腹手术治疗,比较两组患者治疗前和治疗第7d免疫水平CD3~+、CD4~+、CD8~+、CD4~+/CD8~+指标,观察两组患者术中出血量、清扫淋巴数量、排气时间、住院时间及术后并发症情况。结果:腹腔镜组患者术中出血量、术后排气时间、进食时间、术后住院时间均少于开腹组;腹腔镜组患者术中淋巴结清扫数目多于开腹组患者;术后第7d开腹组患者的CD3~+、CD4~+、CD8~+、CD4~+/CD8~+均低于腹腔镜组患者;腹腔镜组围手术期并发症发生率6.7%低于开腹组23.3%(P<0.05)。结论:与开腹手术比较,腹腔镜胃癌根治术对患者机体免疫功能干扰较少,并发症少、患者恢复快,具有临床中推广价值。
Objective:To study and analyze theeffect of laparoscopic radical gastrectomy on treatment effect and immune level in early patients with gastric cancer.Methods:60 cases of patients with gastric cancer treated in a hospital from March 2014 to August 2017 were selected and divided into the laparoscopic group and the open group according to different operative methods,with 30 cases in each group.The two groups were treated with laparoscopic surgery and laparotomy respectively.Then the levels of CD3~+,CD4~+,CD8~+and CD4~+/CD8~+were compared between the two groups before treatment and on the 7 th day after treatment,and the amount of bleeding during operation,the number of lymphatic dissection,the time of exhaust,hospitalization time and postoperative complications of two groups were observed.Results:The amount of bleeding during operation,postoperative exhaust time,eating time,and the postoperative hospitalization time in the laparoscopic group were less than those in the open group,and the number of lymph node dissection in laparoscopic group was higher than that in open group.The levels of CD3~+,CD4~+,CD8~+and CD4~+/CD8~+on the 7 th day after treatment in the laparotomy group were lower than those in the open group.The incidence of perioperative complications in laparoscopic group was 6.7%,which was lower than that in open group(23.3%)(P<0.05).Conclusion:Compared with open surgery,laparoscopic radical gastrectomy has less interference of immune function,less complications and faster recovery in patients with gastric cancer,which is worthy of clinical promotion.
Objective:To study and analyze theeffect of laparoscopic radical gastrectomy on treatment effect and immune level in early patients with gastric cancer.Methods:60 cases of patients with gastric cancer treated in a hospital from March 2014 to August 2017 were selected and divided into the laparoscopic group and the open group according to different operative methods,with 30 cases in each group.The two groups were treated with laparoscopic surgery and laparotomy respectively.Then the levels of CD3~+,CD4~+,CD8~+and CD4~+/CD8~+were compared between the two groups before treatment and on the 7 th day after treatment,and the amount of bleeding during operation,the number of lymphatic dissection,the time of exhaust,hospitalization time and postoperative complications of two groups were observed.Results:The amount of bleeding during operation,postoperative exhaust time,eating time,and the postoperative hospitalization time in the laparoscopic group were less than those in the open group,and the number of lymph node dissection in laparoscopic group was higher than that in open group.The levels of CD3~+,CD4~+,CD8~+and CD4~+/CD8~+on the 7 th day after treatment in the laparotomy group were lower than those in the open group.The incidence of perioperative complications in laparoscopic group was 6.7%,which was lower than that in open group(23.3%)(P<0.05).Conclusion:Compared with open surgery,laparoscopic radical gastrectomy has less interference of immune function,less complications and faster recovery in patients with gastric cancer,which is worthy of clinical promotion.
引文
1全信保,邹佩钢,杨学军,等.腹腔镜与开腹胃癌根治术对高龄胃癌患者免疫功能及近期疗效的对比研究.川北医学院学报,2017,32(1):46~47.
2 彭超,刘宏斌.腹腔镜胃癌根治术对患者免疫功能的影响.医学综述,2013,19(6):1026~1028.
3 曾国祥,黄修仿,彭甫圣.腹腔镜辅助胃癌根治术的临床疗效和对患者外周血免疫功能水平的影响.实用癌症杂志,2017,32(1):44~45.
4 于云雷,宋成飞,王江.腹腔镜胃癌根治术在早期胃癌治疗中对患者免疫水平和临床疗效的影响.中国医药指南,2018,16(2):130~131.
5 王彬,于耀军.腹腔镜胃癌根治术与开腹手术对胃癌患者凝血功能及免疫功能的影响.中国现代医生,2015,53(10):5~6.
6 葛廷建,王敬华.腹腔镜与开腹胃癌根治术疗效及对机体免疫功能影响的比较.中国肿瘤临床与康复,2017,10:1190~1193.
7 黄灵,杜义安,俞鹏飞.腹腔镜胃癌根治术与开腹胃癌根治术对机体炎性反应和满意功能的影响.中国现代医生,2015,53(17):25~26.
2 彭超,刘宏斌.腹腔镜胃癌根治术对患者免疫功能的影响.医学综述,2013,19(6):1026~1028.
3 曾国祥,黄修仿,彭甫圣.腹腔镜辅助胃癌根治术的临床疗效和对患者外周血免疫功能水平的影响.实用癌症杂志,2017,32(1):44~45.
4 于云雷,宋成飞,王江.腹腔镜胃癌根治术在早期胃癌治疗中对患者免疫水平和临床疗效的影响.中国医药指南,2018,16(2):130~131.
5 王彬,于耀军.腹腔镜胃癌根治术与开腹手术对胃癌患者凝血功能及免疫功能的影响.中国现代医生,2015,53(10):5~6.
6 葛廷建,王敬华.腹腔镜与开腹胃癌根治术疗效及对机体免疫功能影响的比较.中国肿瘤临床与康复,2017,10:1190~1193.
7 黄灵,杜义安,俞鹏飞.腹腔镜胃癌根治术与开腹胃癌根治术对机体炎性反应和满意功能的影响.中国现代医生,2015,53(17):25~26.