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目的探讨不同手术方式对直肠癌患者术后感染病原菌种类及免疫功能的影响,从而为选择合适的手术方案提供依据。方法选取2011年5月-2015年5月医院收治的直肠癌患者120例,根据手术方式将其分为腹腔镜组62例与传统开腹组58例,对术后感染患者进行病原菌培养和鉴定,并对免疫功能进行检测,数据采用SPSS 19.0软件进行统计分析。结果腹腔镜组患者感染率为19.35%,传统开腹组患者感染率为36.21%,两组比较差异有统计学意义(P<0.05);腹腔镜组患者共检出病原菌19株,其中革兰阳性菌占36.84%,革兰阴性菌占63.16%,传统开腹组患者共检出病原菌32株,其中革兰阳性菌占34.38%,革兰阴性菌占65.62%,两组病原菌分布差异无统计学意义;腹腔镜组患者术后干扰素-γ(IFN-γ)、白细胞介素-2(IL-2)水平与传统开腹组患者相比明显升高,白细胞介素-10(IL-10)下降,两组比较差异有统计学意义(P<0.05)。结论腹腔镜手术治疗直肠癌患者可以降低术后感染率,且免疫功能恢复更快,与传统开腹手术相比,具有很大优势。
Objective To investigate the effects of different surgical methods on the types of pathogenic bacteria and immunological function of postoperative patients with rectal cancer and to provide basis for selecting appropriate surgical plans. Methods 120 patients with rectal cancer admitted to our hospital from May 2011 to May 2015 were divided into laparoscopic group (62 cases) and traditional laparotomy group (58 cases) according to the way of operation. The pathogenic bacteria were cultured and identified in patients with postoperative infection , And the immune function was tested. The data were analyzed by SPSS 19.0 software. Results The infection rate of laparoscopic group was 19.35%, the infection rate of traditional laparotomy group was 36.21%, the difference between the two groups was statistically significant (P <0.05); 19 strains of pathogenic bacteria were detected in laparoscopic group, of which Gram Positive bacteria accounted for 36.84%, Gram-negative bacteria accounted for 63.16%, traditional open group of patients were detected in 32 strains of pathogens, of which Gram-positive bacteria accounted for 34.38%, Gram-negative bacteria accounted for 65.62%, no distribution of pathogenic bacteria between the two groups The levels of IFN-γ and IL-2 in laparoscopic group were significantly higher than those in laparotomy group. The levels of interleukin-10 (IL- 10) decreased, the difference between the two groups was statistically significant (P <0.05). Conclusion Laparoscopic surgery for patients with rectal cancer can reduce the postoperative infection rate, and immune function recovery faster, compared with the traditional open surgery, has great advantages.