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目的探讨腹腔镜胃癌根治术对患者术后自然杀伤(NK)细胞比例的影响。方法选取行胃癌根治术的患者152例,根据手术方式不同,将患者分为腹腔镜组(行腹腔镜胃癌根治术,74例)和开腹组(行开腹胃癌根治术,78例),通过流式细胞仪检测胃癌患者外周静脉血中NK细胞的比例,分析两组患者术前1 d、术后2 d、术后1周及术后2周NK细胞比例的变化,探讨不同手术方式对机体免疫功能的影响。结果腹腔镜组患者的手术时间、术中出血量、肛门排气时间及住院时间均明显少于开腹组,差异有统计学意义(均P<0.05)。术后2 d与术前1 d比较,腹腔镜组和开腹组患者NK细胞比例均明显下降,差异有统计学意义(P<0.05);腹腔镜组患者术后1周NK细胞比例恢复近术前水平,而开腹组患者术后1周NK细胞比例仍处于低水平,术后2周才恢复近术前水平;腹腔镜组和开腹组患者NK细胞比例变化比较,差异有统计学意义(P<0.05)。结论与传统开腹胃癌根治术相比,腹腔镜胃癌根治术对机体损伤小,能够保护机体免疫功能,术后患者恢复快,值得临床推广应用。
Objective To investigate the effect of laparoscopic radical gastrectomy on the proportion of natural killer (NK) cells in patients after operation. Methods Fifty-two patients undergoing radical gastrectomy were divided into laparoscopic group (74 cases) and open group (78 cases) undergoing laparoscopic radical gastrectomy, according to different surgical methods. The proportion of NK cells in peripheral venous blood of patients with gastric cancer was detected by flow cytometry. The changes of NK cells on the first day, the second day after operation, the second week after operation and the second week after operation were analyzed to explore the different operation methods Impact on the body’s immune function. Results The operation time, intraoperative blood loss, anal exhaust time and hospitalization time in the laparoscopic group were significantly less than those in the laparotomy group (all P <0.05). The proportion of NK cells in laparoscopic group and laparotomy group was significantly decreased on the 2nd day and the 1st day after operation (P <0.05). The proportion of NK cells in laparoscopic group recovered nearly one week after operation Preoperative level, and open laparotomy group 1 week after the proportion of NK cells is still low, 2 weeks after surgery to restore near preoperative level; laparoscopic group and open group patients NK cell ratio changes, the difference was statistically significant Significance (P <0.05). Conclusion Compared with the traditional radical operation of laparoscopic radical gastrectomy, laparoscopic radical gastrectomy has less damage to the body and protects the immune function of the body. The postoperative recovery of patients is worthy of clinical application.