【摘要】 目的探讨腹腔镜下结直肠癌手术的低侵袭性。方法将符合纳入研究对象标准的40例结直肠癌患者随机分成腹腔镜组(20例)和开腹组(20例),比较两组患者围手术期(术前、术后当天、术后第1、3、5d)的外周血白介素(IL)-6、IL-8、肿瘤坏死因子(TNF)-α、C反应蛋白(CRP)、可溶性细胞间黏附分子(sICAM-1)、白细胞CD11b的变化。结果开腹组术后细胞因子(TNF-α、IL-6、IL-8)明显高于腹腔镜组(P<0.05)。开腹组术后6h、第1天时,sICAM-1的动态变化较腹腔镜组显著升高,开腹组外周血白细胞CD11b在术后6h降至最低(161.98±48.42),较腹腔镜组(189.51±46.45)明显低(P<0.05)。结论结直肠癌的腹腔镜手术比传统开腹手术对机体影响小,具有明显的低侵袭性。更多还原

【Abstract】 Objective To investigate the minimal invasiveness of lap ar oscopic operation for colorectal carcinoma. Methods Forty cases with pathologica lly proven colorectal carcinoma were divided into laparoscopic group (n=20) and open surgical group (n=20). Perioperative alterations of peripheral blood IL-6 ,IL-8,TNF-α ,CRP,sICAM-1 and WBC CD11b were compared between the two grou ps. TNF-α ,IL-6,IL-8 and sICAM-1 were determined by ELISA,CRP by scatte red radiation turbidity comparison and WBC CD11b by flow cytometry with monoclon al antibody PS-CD11b,M2Ab. Results The postoperative cytokine levels of TNF- α ,IL-6 and IL-8 in open surgery group were significantly higher than those in laparoscopic group (P< 0.05). Dynamic level of sICAM-1 at 6 and 24 hours a fter operation in open surgery group were significantly higher than those in lap aroscopic group. Peripheral WBC CD11b decreased to the lowest level at 6 hours a fter operation in open surgery group,significantly lower than that in laparoscop ic group(P< 0.05). Conclusion Laparoscopic surgery for colorectal carcinoma exe rts less effects on patients than traditional open surgery,and can maintain pati ents defense function,therefore it is less invasive.更多还原