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目的探讨腹腔镜和开腹胃癌根治术对患者机体炎性反应和免疫功能的影响。方法选取2014年7月至2015年7月间在包头市肿瘤医院行手术治疗的45例胃癌患者的临床资料进行分析。根据手术方式不同将45例患者分为腹腔镜组(20例)和开腹组(25例)。对两组患者的临床疗效、手术前、后血清炎性反应指标和免疫指标进行比较。结果两组患者手术后第1、3、7天外周血CD_3~+、CD_4~+和CD_8~+检测结果较手术前均下降,差异有统计学意义(P<0.05)。手术后第1天两组患者的免疫球蛋白IgG、IgA和IgM水平较术前均下降,差异有统计学意义(P<0.05)。手术后第7天腹腔镜组患者的免疫球蛋白水平已接近手术前(P>0.05),而开腹组仍低于手术前水平(P<0.05)。手术后第1、3天,两组患者的C-反应蛋白(CRP)、白介素6(IL-6)水平均高于手术前,差异有统计学意义(P<0.05);手术后第1天,两组患者的CRP和IL-6的变化差异无统计学意义(P>0.05);手术后第7天,两组患者的CRP和IL-6均有所恢复,但腹腔镜组优于开腹组,差异有统计学意义(P<0.05)。结论与开腹手术比较,腹腔镜手术对机体免疫功能和炎性反应的影响较小,有利于患者机体的恢复,值得临床推广应用。
Objective To investigate the effects of laparoscopic and open radical gastrectomy on the inflammatory reaction and immune function in patients. Methods The clinical data of 45 patients with gastric cancer surgically treated in Baotou Cancer Hospital from July 2014 to July 2015 were analyzed. According to the different surgical methods, 45 patients were divided into laparoscopic group (20 cases) and open group (25 cases). The clinical efficacy of the two groups of patients before and after serum inflammatory response indicators and immune indicators were compared. Results The results of CD_3 ~ +, CD_4 ~ + and CD_8 ~ + in the peripheral blood of the two groups after operation were significantly lower than those before operation (P <0.05). The levels of IgG, IgA and IgM of immunoglobulin in both groups on the first postoperative day were significantly lower than those before operation (P <0.05). The level of immunoglobulin in laparoscopic group was close to that before operation (P> 0.05) and laparoscopic group was still lower than that before operation (P <0.05). The levels of C-reactive protein (CRP) and interleukin 6 (IL-6) in both groups were significantly higher than those before operation on the first and third day after operation (P <0.05). On the first day after operation . There was no significant difference in CRP and IL-6 between the two groups (P> 0.05). On the 7th day after operation, both CRP and IL-6 recovered, but the laparoscopic group was better than the open Abdominal group, the difference was statistically significant (P <0.05). Conclusion Compared with laparotomy, laparoscopic surgery has less effect on the immune function and inflammatory response, which is beneficial to the recovery of the patient’s body, which is worthy of clinical application.