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目的探讨腹腔镜辅助直肠癌根治术在手术时间控制下对患者免疫功能的影响。方法 30例进展期直肠癌患者随机均分为腹腔镜组和开腹组,分别行腹腔镜辅助直肠癌根治术和常规开腹直肠癌根治术,分析两组手术前后血清自然杀伤细胞(NK)、CD3+、CD4+、CD8+、CD4+/CD8+比例的变化。结果两组患者术后CD3+、CD4+和CD4+/CD8+比例均较术前明显降低(P<0.05)。术后第5天,除CD4+/CD8+及NK细胞比例外,腹腔镜组与开腹组其他指标均有不同程度回升,但腹腔镜组恢复程度要优于开腹组(P<0.05);术后CD4+/CD8+比例虽然两组均持续下降,但腹腔镜组下降程度要弱于开腹组。术后第1、5天,两组NK细胞均无明显差异(P>0.05)。结论与常规开腹手术比较,腹腔镜辅助直肠癌根治术创伤小,对患者术后免疫功能影响较少。
Objective To investigate the effect of laparoscopic-assisted radical mastectomy on immune function under the control of operation time. Methods Thirty patients with advanced colorectal cancer were randomly divided into laparoscopic group and laparotomy group. Laparoscopic radical rectal cancer radical mastectomy and conventional open radical rectal cancer radical mastectomy were performed respectively. Serum natural killer (NK) , CD3 +, CD4 +, CD8 +, CD4 + / CD8 + ratio changes. Results The postoperative CD3 +, CD4 + and CD4 + / CD8 + ratios of the two groups were significantly lower than those before the operation (P <0.05). On the 5th postoperative day, except for the proportion of CD4 + / CD8 + and NK cells, the other indexes of laparoscopic group and laparotomy group rose to some extent, but the degree of recovery of laparoscopic group was better than that of laparotomy group (P <0.05) After the CD4 + / CD8 + ratio Although both groups continued to decline, but laparoscopic group decreased less than the open group. On the first and fifth day after operation, there was no significant difference between the two groups of NK cells (P> 0.05). Conclusion Compared with conventional laparotomy, laparoscopic radical resection of rectal cancer is less traumatic and has less impact on postoperative immune function.