解放军医学院学报2017，Vol.38Issue(5)：395-398,4.DOI:10.3969/j.issn.2095-5227.2017.05.002
比较腹腔镜辅助与开腹胃癌根治术对患者急性期反应及细胞免疫功能的影响
Effect of laparoscopic-assisted radical gastrectomyvs open radical gastrectomy on acute phase response and cellular immune function: A comparative study
摘要
Abstract
Objective To compare the effects of laparoscopic-assisted radical gastrectomy and open radical gastrectomy on acute phaseresponse and cellular immune function. Methods Retrospective clinicopathologic data of 179 patients with gastric cancer from September 2014 to September 2015 in the Department of Chinese PLA General Hospital was collected. Of which, 82 cases underwent laparoscopicassisted gastrectomy (laparoscopic group), and 97 cases with open radical gastrectomy (open group). The baseline data of the two groups showed no statistically significant difference(P > 0.05). The levels of CRP, IL-6, lymphocyte count, neutrophil count, neutrophil count/ lymphocyte count ratio in the two groups were compared preoperatively and at day 1, 2, 3, 7 after the operation. Results Compared with the laparotomy group, the laparoscopic group had less blood loss[(152.32±98.18)ml vs (238.97±138.03) ml, P < 0.05], slightlylonger operative time [(211.44±54.58) min vs (191.32±50.15) min, P < 0.05]and similar dissected lymph nodes [(25.26±1.44) vs (24.97±1.94), P > 0.05]. The CRP, IL-6 level, neutrophil count, lymphocyte count, neutrophil count / lymphocyte count ratio were within the normal range with no significant difference (P > 0.05). The levels of CRP and IL-6 were significantly increased on day 1, 2,3, 7 after operation (P < 0.05); CRP peaked on day 2 after operation and IL- 6 peaked on day 1 after operation (P < 0.05, respectively); The levels of CRP and IL-6 in the laparoscopic group were lower than those in the laparotomy group at day 1, 2, 3, 7 after operation (P < 0.05, respectively). The neutrophil count and neutrophil count / lymphocyte count ratio in two groups at day 1, 2, 3, 7 after operation were significantly higher than those before operation (P < 0.05, respectively) and the lymphocyte counts were significantly lower than thosebefore operation (P < 0.05, respectively); The neutrophil count, neutrophil count / lymphocyte count ratio peaked on day 1 after operation, and lymphocyte count at day 1 after surgery decreased to a minimum; The levels of neutrophil count and neutrophil count / lymphocyte count ratio in the laparoscopic group were lower than those in the laparotomy group at day 1, 2, 3, 7 after operation, while the level of lymphocyte count was higher (P < 0.05, respectively). Conclusion Compared with open surgery, laparoscopic surgery has less bleeding with the same effect and longer operative time. The acute phase reaction and the degree of cellular immunosuppression are less than those of open surgery, probably due to the smaller trauma and internal environment interference of the laparoscopic surgery.关键词
腹腔镜/胃癌/C反应蛋白/白细胞介素-6/细胞免疫Key words
laparoscopy/gastric cancer/C-reactive protein/interleukin- 6/cellular immunity分类
医药卫生引用本文复制引用
胡时栋,杨宇,王玉锋,杜晓辉,胡子龙,邹贵军,吴有军,邢晓伟,李宇轩,张凯,何长征,王迪..比较腹腔镜辅助与开腹胃癌根治术对患者急性期反应及细胞免疫功能的影响[J].解放军医学院学报,2017,38(5):395-398,4.基金项目
国家自然科学基金项目(61471397) Supported by the National Natural Science Foundation of China (61471397) （61471397）
