腹腔镜手术治疗直肠癌后机体炎症情况分析(1)
【摘要】 目的：探讨腹腔镜手术和传统开腹手术治疗直肠癌后机体炎症因子的变化情况，以帮助临床选择更好的治疗直肠癌的手术方法。方法：选取2012年6月-2014年9月本院收诊的直肠癌患者50例，按照手术方式不同将其分为试验组(腹腔镜手术)和对照组(传统开腹手术)，各25例。比较两组术前及术后1、7 d炎症因子TNF-α、IL-6、CRP、MCP-1水平及免疫细胞CD3+、CD4+、CD8+、NK细胞的活性。结果：术前，两组各炎症因子及免疫细胞活性比较，差异均无统计学意义(P>0.05)；术后1、7 d，试验组TNF-α、IL-6、CRP、MCP-1水平均低于对照组，差异均有统计学意义(P<0.05)，试验组CD3+、CD4+、CD8+及NK细胞活性均显著高于对照组，差异均有统计学意义(P<0.05)。结论：治疗直肠癌时采用腹腔镜手术比传统开腹手术能够减少机体的炎症反应、维持免疫功能，值得在临床上推广。
【关键词】 直肠癌； 腹腔镜； 炎症因子
Analysis of Postoperative Inflammation in Patients with Rectal Cancer Treated by Laparoscopic Surgery/LIU Hongfu，DENG Yungang，ZHANG Lei，et al.//Medical Innovation of China，2018，15(03)：011-014
【Abstract】 Objective：To investigate the changes of inflammatory factors after laparoscopic surgery and traditional open surgery for rectal cancer，and to help choose better surgical treatment of rectal cancer.Method：A total of 50 patients with rectal cancer received in our hospital from June 2012 to September 2014 were selected.According to the different surgical methods，they were divided into experimental group(laparoscopic surgery) and control group(traditional open surgery)，25 cases in each group.The levels of inflammatory factors TNF-α，IL-6，CRP，MCP-1 and activity of immunocyte CD3+，CD4+，CD8+ and NK cells before and after the operation 1 and 7 d between two groups were compared.Result：Before operation，the inflammatory factors and immune cell activity in two groups were compared，the differences were not statistically significant(P>0.05).After operation 1 and 7 d，the levels of TNF-α，IL-6，CRP，MCP-1 in experimental group were lower than those of control group，the differences were statistically significant(P<0.05)，the activities of CD3+，CD4+，CD8+ and NK cells in experimental group were significantly higher than those of control group，the differences were statistically significant(P<0.05).Conclusion：In the treatment of rectal cancer，laparoscopic surgery can reduce the body’s inflammatory response and maintain the immune function than traditional open surgery，which is worth popularizing in the clinic.
【Key words】 Rectal cancer； Laparoscopic surgery； Inflammatory factors
First-author’s address：First Affiliated Hospital of Gannan Medical College，Ganzhou 341000，China
doi：10.3969/j.issn.1674-4985.2018.03.003
直腸癌是指从齿状线至直肠乙状结肠交界处之间的癌症，是消化道系统最常见的恶性肿瘤之一。研究数据发现，2017年我国结直肠癌发病率、死亡率都很高，而且新发病例约为37.6万，死亡病例19.1万，已成为严重危害中国人健康的疾病[1-2]。腹腔镜结肠癌根治术已经作为一个标准的手术方式被广泛接受，但在直肠癌方面的应用，腹腔镜手术却一直没有大的进展[3]。2016年COLORⅡ研究表明，支持腹腔镜手术用于直肠癌根治切除，而且在直肠癌根治术的疗效方面，腹腔镜与传统开腹手术一样，某些方面甚至还有优势[4]。然而，近两年另外两个类似研究在其他杂志报道了完全相反的结果，北美的ACOSOGZ605研究和大洋洲的ALaCaRT研究均未能证实腹腔镜直肠癌手术与传统开腹手术在肿瘤学疗效方面的优劣[5-6]。因此，本文选取2012年6月-2014年9月本院收诊的直肠癌患者50例，分别检测术前及术后1、7 d炎症因子TNF-α、IL-6、CRP、MCP-1水平及免疫细胞CD3+、CD4+、CD8+、NK活性的情况，以期帮助临床选择更好的治疗直肠癌的手术方法。现报道如下。, http://www.100md.com(刘洪福 邓云刚 张蕾)
【关键词】 直肠癌； 腹腔镜； 炎症因子
Analysis of Postoperative Inflammation in Patients with Rectal Cancer Treated by Laparoscopic Surgery/LIU Hongfu，DENG Yungang，ZHANG Lei，et al.//Medical Innovation of China，2018，15(03)：011-014
【Abstract】 Objective：To investigate the changes of inflammatory factors after laparoscopic surgery and traditional open surgery for rectal cancer，and to help choose better surgical treatment of rectal cancer.Method：A total of 50 patients with rectal cancer received in our hospital from June 2012 to September 2014 were selected.According to the different surgical methods，they were divided into experimental group(laparoscopic surgery) and control group(traditional open surgery)，25 cases in each group.The levels of inflammatory factors TNF-α，IL-6，CRP，MCP-1 and activity of immunocyte CD3+，CD4+，CD8+ and NK cells before and after the operation 1 and 7 d between two groups were compared.Result：Before operation，the inflammatory factors and immune cell activity in two groups were compared，the differences were not statistically significant(P>0.05).After operation 1 and 7 d，the levels of TNF-α，IL-6，CRP，MCP-1 in experimental group were lower than those of control group，the differences were statistically significant(P<0.05)，the activities of CD3+，CD4+，CD8+ and NK cells in experimental group were significantly higher than those of control group，the differences were statistically significant(P<0.05).Conclusion：In the treatment of rectal cancer，laparoscopic surgery can reduce the body’s inflammatory response and maintain the immune function than traditional open surgery，which is worth popularizing in the clinic.
【Key words】 Rectal cancer； Laparoscopic surgery； Inflammatory factors
First-author’s address：First Affiliated Hospital of Gannan Medical College，Ganzhou 341000，China
doi：10.3969/j.issn.1674-4985.2018.03.003
直腸癌是指从齿状线至直肠乙状结肠交界处之间的癌症，是消化道系统最常见的恶性肿瘤之一。研究数据发现，2017年我国结直肠癌发病率、死亡率都很高，而且新发病例约为37.6万，死亡病例19.1万，已成为严重危害中国人健康的疾病[1-2]。腹腔镜结肠癌根治术已经作为一个标准的手术方式被广泛接受，但在直肠癌方面的应用，腹腔镜手术却一直没有大的进展[3]。2016年COLORⅡ研究表明，支持腹腔镜手术用于直肠癌根治切除，而且在直肠癌根治术的疗效方面，腹腔镜与传统开腹手术一样，某些方面甚至还有优势[4]。然而，近两年另外两个类似研究在其他杂志报道了完全相反的结果，北美的ACOSOGZ605研究和大洋洲的ALaCaRT研究均未能证实腹腔镜直肠癌手术与传统开腹手术在肿瘤学疗效方面的优劣[5-6]。因此，本文选取2012年6月-2014年9月本院收诊的直肠癌患者50例，分别检测术前及术后1、7 d炎症因子TNF-α、IL-6、CRP、MCP-1水平及免疫细胞CD3+、CD4+、CD8+、NK活性的情况，以期帮助临床选择更好的治疗直肠癌的手术方法。现报道如下。, http://www.100md.com(刘洪福 邓云刚 张蕾)
参见：首页 > 医疗版 > 疾病专题 > 消化内科 > 肠道疾病 > 类癌及类癌综合征 > 结、直肠癌