微创医学

目的对比传统开腹手术与腹腔镜结直肠癌手术对机体免疫功能的影响。方法将80例结直肠癌手术的患者分为两组，其中腹腔镜手术组40例，传统开腹组40例。分别在术前、术后第1天、术后第4天、术后第7天抽取患者外周静脉血，采用流式细胞术分析法检测CD4+、CD8+及NK细胞的变化。结果传统开腹组与腹腔镜手术组CD4+、CD8+及NK术前差异均无统计学意义（P＞0.05）。术后1 d两组CD4+含量明显下降，4 d后均恢复到术前水平，组间差异均无统计学意义（P＞0.05）；术后1 d CD8+无明显变化，术后4 d两组CD8+均下降，术后7 d开腹组明显低于腹腔镜组，差异有统计学意义（P＜0.05）；术后1 d NK开腹组显高于腔镜组（P＜0.05），随后两组逐渐恢复到术前水平。结论腹腔镜结直肠癌对机体免疫功能的影响比开腹手术小。

ObjectiveTo compare the effect of traditional open and laparoscopic colorectal cancer on immune function. MethodsEighty cases of colorectal ca ncer operation were divided into laparoscopy group and traditional laparotomy group, 40 cases for each group. Peripheral venous blood sampling was made to measure CD4+, CD8+ and NK cells by flow cytometry at before, 1 day after, 4 days after, and 7 days af ter operation. ResultsNo statistical difference was detected in CD4+, CD8+ and NK before operation between the two groups (P ＞0.05). CD4+ of both two groups significantly decreased 1 d after operation, but recovered to the preoperative level at 4 days after operation, with no statistical difference between the two groups (P＞0.05). CD8+ of both groups showed no significant change 1 day after operation, and both decreased obviously at 4 days after operation, but the level of traditional open group was significantly lower than that of the laparoscopy group at 7 days after operation(P＜0.05). NK level of the traditional open group was significantly higher than that of the laparoscopy group 1 day after operation(P＜0.05), but restored to preoperative level at 7 days after in both groups. ConclusionLaparoscopic colorectal cancer operation has a much smaller effect on immune function than open operation.