【摘要】 目的比较腹腔镜和开腹胃癌根治术对机体免疫功能的影响。方法回顾性分析90例胃癌根治术患者,按照手术方式分为腹腔镜组(n=45)和开腹组(n=45),比较两组患者术前及术后第3、10天外周血Ig G、Ig M、Ig A、CD3~+、CD4~+、CD8~+、NK细胞活性。结果腹腔镜组术中出血量少于开腹组,且下床活动时间早(P﹤0.05);两组手术时间、肛门排气时间和术后并发症总发生率的差异无统计学意义(P﹥0.05);术后第3天,两组患者Ig G、Ig M、Ig A、CD3~+、CD4~+、CD4~+/CD8~+和NK细胞活性较术前均降低(P﹤0.05),组间差异无统计学意义(P﹥0.05);术后第10天,开腹组上述指标仍低于术前(P﹤0.05),腹腔镜组接近术前水平(P﹥0.05),腹腔镜组Ig M、CD3~+和CD4~+高于开腹组(P﹤0.05),Ig A、Ig G、CD4~+/CD8~+和NK细胞活性组间差异无统计学意义(P﹥0.05)。结论腹腔镜和开腹胃癌根治术后患者的免疫功能均降低;与开腹手术相比,腹腔镜术后机体免疫功能恢复较快。更多还原

【Abstract】 Objective To compare the effects of laparoscopic and laparotomy in radical gastrectomy on the immune function of patients with gastric cancer. Method 90 cases of gastric cancer patients were stratified as laparoscopy group(n=45) and laparotomy group according to respective surgery mode(n=45). The preoperative and postoperative levels of Ig G, Ig M, Ig A, CD3~+, CD4~+, CD8~+and NK cell activity in peripheral blood of both groups were detected by flow cytometry. Result The blood loss in laparoscopy group was significantly less than that in the laparotomy group, with earlier ambulation observed in the former(P<0.05); There was no significant difference in operative time, anal exhaust time and post- operative complication rate between the two groups(P>0.05); On day 3 after surgery, the level of Ig G, Ig M, Ig A,CD3~+, CD4~+, NK and the ratio of CD4~+/ CD8~+were significantly decreased in both groups as compared to those before surgery(P<0.05), but there was no statistical difference observed(P>0.05); On day 10 after surgery, the parameters stated above recovered rapidly in laparoscopy group(P>0.05), but still remained low in laparotomy group(P<0.05); The activity of Ig A, Ig G, CD4~+/ CD8~+and NK cells were similar between the two groups(P>0.05). Conclusion The immune function of the patients was consistently weakened after either laparoscopy or laparotomy; While rapid recovery of immune function is expectable after laparoscopic surgery.更多还原