腹腔镜与开腹结直肠癌根治术对机体免疫系统影响的比较研究.DOCVIP

临床医学论文-腹腔镜与开腹结直肠癌根治术对机体免疫系统影响的比较研究 【摘要】? 目的：比较腹腔镜手术与传统开腹手术对患者免疫机能的影响。方法：2006年12月至2007年7月收治结直肠癌患者60例，分别行腹腔镜手术和开腹手术各30例，于术前1d和术后第3天、第7天抽取外周静脉血,比较两组患者的C反应蛋白，IgA,IgM,IgG,IL6,CD3+,CD4+,CD8+细胞和NK细胞，比较术前1d和术后第1天、第3天TNFα细胞活性。结果：术后第3天患者CD3+,CD4+,CD8+细胞活性及CD4+/CD8+差异无显著性，但术后第7天腹腔镜较开腹组明显低。术后第3天IL6开腹组明显高于腹腔镜组。C反应蛋白于术后第3天开腹组高于腹腔镜组。IgM于术后第3天开腹组高于腹腔镜组，IgA、IgG无显著统计学意义。TNFα于术后第3天开腹组高于腹腔镜组。结论：腹腔镜结直肠癌根治术较传统开腹手术对机体免疫机能影响较小。 【关键词】? 结直肠肿瘤；腹腔镜术；免疫测定 ??? The comparison of effects of laparoscopic radical operation and open operation on immune system YANG Shuo,ZHANG Jianli.Dept.of General Surgery,the Affiliated Hospital of Qingdao University,Qingdao 266021,China ??? 【Abstract】? Ｏbjective:To compare the influence of laparoscopic radical operation and open operation on systematic immunity in patients with colorectal carcinoma.Methods:Collecting sixty patients with colorectal carcinoma from Nov.2006 to Jul.2007,the patients were randomly divided into two groups(laparoscopic operation and open operation),each group with 30 cases.NK cell,IgA,IgM,IgG,IL6,IL8,CD3+,CD4+,CD8+ in peripheral blood were counted and compared on the 1st day before operation,the 3rd and 7th day after operation.TNFα in peripheral blood was counted and compared on the 1st day before operation the 1st and 3rd day after operation.Results:CD3+,CD4+,CD8+，CD4+/CD8+ of laparoscopic radical operation were significantly lower than those of open operation on the 7th day after the operation.IgM,IL6,CRP,TNFα of laparoscopic radical operation were significantly lower than those of open operation on the 3rd day after the operation.There were no significant difference of IgA,IgG and NK cell.Conclusions:Compared with the radical open operation,the systematic immune response after the laparoscopic radical operation is less,which means the laparoscopic radical operation has predominance in protecting immune system in treating colorectal carcinoma. ??? 【Key words】? Colorectal neoplasms;Laparoscopy;Immunoassay ??? 腹腔镜手术现已在外科领域得到广泛应用