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目的:分析腹腔镜下根治性膀胱切除术治疗膀胱癌的疗效及对血清白细胞介素-6(IL-6)、干扰素-γ(IFN-γ)的影响。方法:将106例膀胱癌患者参照随机数表法分作对照组与实验组,对照组予以开放根治性膀胱切除术,实验组予以腹腔镜下根治性膀胱切除术。观察并比较两组患者术中出血量、肛门排气时间、住院时间、手术时间、淋巴结清扫阳性率,血清IL-6,IFN-γ,P物质,前列腺素E2(PGE2),CD3~+,CD4~+,CD8~+,纤维蛋白原(Fg),活化部分凝血活酶时间(APTT),凝血酶原时间(PT)及并发症的发生率。结果:实验组出血量、肛门排气时间、住院时间少于对照组,但手术时间多于对照组,差异具有统计学意义(P<0.05);两组淋巴结清扫阳性率、Fg、APTT、PT比较无差异(P>0.05)。实验组IL-6,P物质,PGE2,CD8~+均低于对照组,但IFN-γ,CD3~+,CD4~+及CD4~+/CD8~+均高于对照组(P<0.05)。实验组并发症率低于对照组(P<0.05)。结论:腹腔镜下根治术膀胱癌切除术治疗膀胱癌的疗效肯定,对血清IL-6及IFN-γ的影响较小,并可抑制疼痛应激指标的分泌,保护机体免疫功能。
Objective: To analyze the curative effect of laparoscopic radical cystectomy on bladder cancer and its effect on serum interleukin-6 (IL-6) and interferon-γ (IFN-γ). Methods: 106 patients with bladder cancer were divided into control group and experimental group according to the random number table. The control group was treated with radical cystectomy. In the experimental group, laparoscopic radical cystectomy was performed. The blood loss, anal exhaust time, hospitalization time, operative time, positive rate of lymph node dissection, serum IL-6, IFN-γ, substance P, prostaglandin E2 (PGE2), CD3 + CD4 ~ +, CD8 ~ +, fibrinogen (Fg), activated partial thromboplastin time (APTT), prothrombin time (PT) and the incidence of complications. Results: The bleeding volume, exhaust time and hospital stay in the experimental group were less than those in the control group, but the operation time was longer than that in the control group (P <0.05). The positive rate of lymph node dissection, Fg, APTT, PT No difference (P> 0.05). The levels of IL-6, P, PGE2 and CD8 + in experimental group were lower than those in control group, but the levels of IFN-γ, CD3 +, CD4 + and CD4 + / CD8 + . The complication rate of experimental group was lower than that of control group (P <0.05). Conclusions: The curative effect of laparoscopic radical resection of bladder cancer in the treatment of bladder cancer is affirmative, it has little influence on serum IL-6 and IFN-γ, and can inhibit the secretion of pain and stress indicators and protect the immune function.