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目的:探讨腹腔镜和开腹结直肠癌根治术对机体免疫功能的影响。方法:2003年12月至2006年3月,同一手术组将60例结直肠癌患者随机分为腹腔镜组和开腹组,各30例。分别于术前1d和术后第3天、1、2周取外周静脉血,测定C反映蛋白(CRP)、IL-6、免疫球蛋白IgA、Ig M、IgG,CD3+、CD4+、CD8+及NK细胞活性进行比较。结果:术后第3天,两组患者外周血CD3+、CD4+、CD4+/CD8+及NK细胞活性比较无显著性差异(P>0·05),开腹组患者术后第1周、2周显著低于腹腔镜组(P<0·01)。IL-6术后第1、3天,开腹组明显高于腹腔镜组(P<0·01)。CRP术后第3、7天,开腹组明显高于腹腔镜组(P<0·01,P<0·05)。Ig M术后第3天腹腔镜组高于开腹组(P<0·05),IgA,IgG两组间无统计学差异(P>0·05)。结论:腹腔镜结直肠癌根治术比传统开腹手术对机体影响小,在免疫功能保护上更具有优势。
Objective: To investigate the effect of laparoscopic and open radical colorectal cancer radical surgery on immune function. Methods: From December 2003 to March 2006, 60 patients with colorectal cancer were randomly divided into laparoscopic group and open group with 30 cases in the same operation group. Peripheral venous blood was taken 1 day before surgery and 3 days, 1 and 2 weeks after surgery, and C-reactive protein (CRP), IL-6, immunoglobulin IgA, Ig M, IgG, CD3+, CD4+, CD8+, and NK were measured. Cell activity was compared. Results: On the third day after operation, there was no significant difference in the activity of CD3+, CD4+, CD4+/CD8+ and NK cells in the peripheral blood between the two groups (P>0.05). The patients in the open group had significant 1 week and 2 weeks after operation. Lower than the laparoscopic group (P <0. 01). On the 1st and 3rd day after IL-6, the laparotomy group was significantly higher than the laparoscopic group (P<0.01). On the third and seventh day after CRP, the laparotomy group was significantly higher than the laparoscopic group (P<0.01, P<0.05). On the third day after IgM, laparoscopic group was higher than open group (P<0.05). There was no statistical difference between IgA and IgG (P>0.05). Conclusion: Laparoscopic radical resection of colorectal cancer has less influence on the body than traditional open surgery, and it has advantages in the protection of immune function.