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目的:探讨腹腔镜辅助下胃癌D2根治术对患者血清炎症因子(IL-6、IL-8及IL-10)的影响。方法:将拟行胃癌D2根治术患者89例,随机分为腹腔镜组(n=45例)及开腹组(n=44例),采集所有患者术前2 d及术后4 h、1d、2 d、4 d的腹腔冲洗液。然后采用酶联免疫吸附双抗体夹心(ELISA)法检测所收集的腹腔冲洗液中IL-6、IL-8及IL-10。采用t检验来统计计量资料,采用χ2检验来统计计数资料。结果:术前2 d两组腹腔冲洗液IL-6、IL-8及IL-10水平比较无统计学差异(t=1.524,t=1.652,t=1.521,P>0.05);术后4 h、1d、2d、4d开腹组腹腔冲洗液IL-6、IL-8水平显著高于腹腔镜组,相比较有统计学差异(t=2.481、2.347、2.132、2.078,P<0.05;t=2.314、2.248、2.041、2.008,P<0.05);IL-10水平明显低于腹腔镜组(t=2.618、2.358、2.145、1.997,P<0.05)。结论:腹腔镜辅助下胃癌D2根治术患者的腹腔局部炎症反应较轻,且腹腔镜辅助下胃癌D2根治术在预防IL-6介导的胃癌腹腔转移方面有价值。
Objective: To investigate the effect of laparoscopic-assisted D2 gastric cancer therapy on serum inflammatory cytokines (IL-6, IL-8 and IL-10) in patients with gastric cancer. Methods: Eighty-nine patients undergoing D2 radical operation of gastric cancer were randomly divided into two groups: laparoscopic group (n = 45) and open group (n = 44) , 2 d, 4 d of abdominal irrigation fluid. The collected IL-6, IL-8 and IL-10 in the peritoneal irrigated fluid were detected by enzyme-linked immunosorbent assay (ELISA). Using t test to measure the measurement data, using χ2 test to count data. Results: There was no significant difference in IL-6, IL-8 and IL-10 levels between two groups before operation (t = 1.524, t = 1.652, t = 1.521, P> 0.05) The levels of IL-6 and IL-8 in laparotomy group were significantly higher than those in laparoscopic group on the 1st, 2nd, 4th day (t = 2.481,2.347,2.132,2.078, P <0.05; t = 2.314,2.248,2.041,2.008, P <0.05). The level of IL-10 was significantly lower than that of laparoscopic group (t = 2.618,2.358,2.145,1.997, P <0.05). Conclusions: The laparoscopic-assisted radical gastrectomy in patients with D2 radical resection has less local peritoneal inflammatory response, and laparoscopic-assisted D2 radical gastrectomy is valuable in the prevention of IL-6-mediated peritoneal metastasis of gastric cancer.