2016 年第 8 期 第 14 卷

不同手术方式对胃癌根治术患者机体免疫功能的影响

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关键词：腹腔镜手术开腹手术胃癌免疫功能

• 摘要：
• 【摘要】摘要：目的 比较腹腔镜和开腹胃癌根治术对机体免疫功能的影响。方法 90例胃癌根治术患者根据手术方式分为腹腔镜组(n =45)和开腹组(n =45)，分别测定两组患者术前及术后第3、10天外周血IgG、IgM、IgA 、CD3+、CD4+、CD8+、NK细胞活性。结果 术后第3天，两组患者IgG、IgM、IgA、CD3+、CD4+、CD4+/ CD8+和NK细胞活性较术前均降低（P <0.05）,组间差异无统计学意义(P >0.05)；术后第10天，开腹组上述指标仍低于术前低（P <0.05），腹腔镜组接近术前水平（P >0.05），腹腔镜组IgM、CD3+和CD4+高于开腹组（P <0.05），IgA、IgG、CD4+/ CD8+和NK细胞活性组间差异无统计学意义（P >0.05）。结论 腹腔镜和开腹胃癌根治术后患者的免疫功能均降低；与开腹手术相比，腹腔镜术后机体免疫功能恢复较快。
• Abstract: Objective To compare the effects of laparoscopic and open radical gastrectomy on immune function in patients with gastric cancer. Methods 90 cases of gastric cancer patients were divided into Laparoscopic group and open group according to the operation mode. Expressed levels of peripheral blood IgG, IgM, IgA, CD3+, CD4+, CD8+ and NK were detected by flow cytometry. On day 3 postoperatively, IgG, IgM, IgA, CD3+, CD4+, NK and the ratio of CD4+/ CD8+ significantly decreased as compared to those preoperatively in two g roups (P<0.05), but there was no statistical difference between two groups (P>0.05); On day 10 postoperatively, the parameters above recovered rapidly in laparoscoptic group, but they kept continuously low in open group, IgM, CD3+ and CD4+ in open group were significantly lower than those in laparoscope group（P <0.05). Conclusion The immune function of the patients was decreased in laparoscopic and open radical gastrectomy. The recovery time of immune function after laparoscopic operation was shorter than that of open surgery.