腹腔镜辅助胃癌D2端根治术治疗胃癌合并2型糖尿病的效果及其对炎症因子和免疫功能的影响(1)
[摘要] 目的 探讨腹腔镜辅助胃癌D2端根治术对胃癌合并2型糖尿病患者的疗效及其对炎症因子和免疫功能的影响。 方法 选取2006年3月～2013年2月崇州市人民医院诊治的68例胃癌合并2型糖尿病患者，按照手术方式的不同分为开腹胃癌D2根治术(开腹组)和腹腔镜辅助胃癌D2根治术(腹腔镜组)，每组各34例。分别观察两组患者的临床治疗效果、炎症因子和免疫功能的变化。 结果 腹腔镜组的治疗有效率为88.24%，略高于开腹组的70.59%，但两组间比较差异无统计学意义(P > 0.05)；开腹组患者平均腹腔引流时间、肛门排气时间均明显长于腹腔镜组(P < 0.05)，术中平均出血量和并发症发生率较腹腔镜组显著增加(P < 0.05)，但平均手术时间却明显少于腹腔镜组(P < 0.05)；两组患者在中位生存时间和清扫淋巴结数量的比较，差异无统计学意义(P > 0.05)。腹腔镜术式对患者空腹血糖和餐后2 h血糖的影响更小(P < 0.05)；两组患者术后白介素(IL)-6、IL-8、IL-12、IL-16、肿瘤坏死因子-α(TNF-α)的水平均较术前显著升高(P < 0.05)，而且开腹组患者上述炎症因子的增加幅度较腹腔镜组更为明显(P < 0.05)；腹腔镜组患者IgA、IgM水平和补体C3含量的改善幅度显著优于开腹组(P < 0.05)。 结论 腹腔镜辅助胃癌D2端根治术对胃癌合并2型糖尿病患者具有良好的效果，对血糖和免疫功能影响较小且可减轻炎性反应。
[关键词] 2型糖尿病；胃癌D2端根治术；腹腔镜；炎症因子；免疫功能
[中图分类号] R735.2 [文献标识码] A [文章编号] 1673-7210(2016)04(b)-0100-04
[Abstract] Objective To explore the clinical curative effects of laparoscopic assisted D2 radical resection on the patients with gastric cancer and type 2 diabetes and its influence on the inflammation factors and immune function. Methods The 68 cases of gastric cancer and type 2 diabetes from March 2006 to February 2013 in People's Hospital of Chongzhou were selected， and they were divided into D2 radical gastrectomy (gastrectomy group) and laparoscopic assisted D2 radical resection (laparoscopic group) according to the different operation methods， with 34 cases in each group. The clinical curative effects and the levels of inflammatory factors and immune function were observed in the two groups. Results The total effective rate of laparoscopic group was 88.24%， it was slightly higher than that of gastrectomy group (70.59%)， but the difference was not statistically significant (P > 0.05)； the average abdominal laparotomy drainage time anal exhaust time of gastrectomy group were significantly longer than those of laparoscopic group (P < 0.05)， and the average intraoperative bleeding volume and incidence of complication were significantly increased than those of laparoscopic group (P < 0.05)， but the average operation time was significantly shorter than the laparoscopic group (P < 0.05)； there were no significant difference on the survival time and the number of lymph node dissection between two groups (P > 0.05)； moreover， the changes on blood glucose and 2 h blood glucose after intake in laparoscopic group were less than gastrectomy group (P < 0.05)； After postoperative， the levels of IL-6， IL-8， IL-12， IL-16， TNF-α and hs-CRP were all significantly increased in both two groups (P < 0.05)， while the inflammatory factors of the gastrectomy group increased more significantly than that in the laparoscopic group (P < 0.05). Moreover， the changed levels of IgA， IgM and complement C3 in the laparoscopic group were significantly better than those in the gastrectomy group (P < 0.05). Conclusion Laparoscopic assisted D2 radical resection has a good curative effect on the gastric cancer and type 2 diabetes， and has litter influence on the blood glucose and immune function， it also can reduce the level of inflammation., 百拇医药(李海 游红勇 陈智敏 李兵 徐建明)
[关键词] 2型糖尿病；胃癌D2端根治术；腹腔镜；炎症因子；免疫功能
[中图分类号] R735.2 [文献标识码] A [文章编号] 1673-7210(2016)04(b)-0100-04
[Abstract] Objective To explore the clinical curative effects of laparoscopic assisted D2 radical resection on the patients with gastric cancer and type 2 diabetes and its influence on the inflammation factors and immune function. Methods The 68 cases of gastric cancer and type 2 diabetes from March 2006 to February 2013 in People's Hospital of Chongzhou were selected， and they were divided into D2 radical gastrectomy (gastrectomy group) and laparoscopic assisted D2 radical resection (laparoscopic group) according to the different operation methods， with 34 cases in each group. The clinical curative effects and the levels of inflammatory factors and immune function were observed in the two groups. Results The total effective rate of laparoscopic group was 88.24%， it was slightly higher than that of gastrectomy group (70.59%)， but the difference was not statistically significant (P > 0.05)； the average abdominal laparotomy drainage time anal exhaust time of gastrectomy group were significantly longer than those of laparoscopic group (P < 0.05)， and the average intraoperative bleeding volume and incidence of complication were significantly increased than those of laparoscopic group (P < 0.05)， but the average operation time was significantly shorter than the laparoscopic group (P < 0.05)； there were no significant difference on the survival time and the number of lymph node dissection between two groups (P > 0.05)； moreover， the changes on blood glucose and 2 h blood glucose after intake in laparoscopic group were less than gastrectomy group (P < 0.05)； After postoperative， the levels of IL-6， IL-8， IL-12， IL-16， TNF-α and hs-CRP were all significantly increased in both two groups (P < 0.05)， while the inflammatory factors of the gastrectomy group increased more significantly than that in the laparoscopic group (P < 0.05). Moreover， the changed levels of IgA， IgM and complement C3 in the laparoscopic group were significantly better than those in the gastrectomy group (P < 0.05). Conclusion Laparoscopic assisted D2 radical resection has a good curative effect on the gastric cancer and type 2 diabetes， and has litter influence on the blood glucose and immune function， it also can reduce the level of inflammation., 百拇医药(李海 游红勇 陈智敏 李兵 徐建明)