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目的探讨超声刀和电刀对直肠癌Miles术后免疫功能和术后应激的影响。方法回顾性分析2007年2月-2012年8月82例直肠癌Miles术患者临床资料,其中45例使用超声刀手术,37例使用电刀手术,比较两组腹部手术时间、会阴部手术时间、术中出血量、术后72 h引流量情况,应用流式细胞仪测定两组外周血中T淋巴细胞亚群CD3+、CD4+、CD8+、CD4+/CD8+比率,术后第3天检测血白细胞计数、粒细胞百分比、C反应蛋白、白介素细胞-6(IL-6)。结果超声刀组与电刀组相比,CD3+、CD4+、CD8+、CD4+/CD8+比率差异无统计学意义(P>0.05);对比术中出血量、腹部手术时间、会阴部手术时间、术后72 h引流量、白细胞计数、粒细胞百分比、C反应蛋白、IL-6,超声刀组均有明显减少,差异有统计学意义(P<0.05)。结论两种手术方式在直肠癌Miles术中切除效果及对术后免疫功能影响无明显差异,但超声刀组术后恢复快且对术后应激反应小,值得临床推广应用。
Objective To investigate the effect of ultrasonic scalpel and electric knife on immune function and post-operative stress in patients with rectal cancer after Miles operation. Methods A retrospective analysis of 82 patients with Miles operation in rectal cancer from February 2007 to August 2012 was performed. Among them, 45 patients underwent ultrasonic knife surgery and 37 patients underwent electric knife surgery. The operative time, perineal operation time, The amount of bleeding during operation and the amount of drainage at 72 hours after operation were measured by flow cytometry. The ratio of CD3 +, CD4 +, CD8 + and CD4 + / CD8 + in peripheral blood T lymphocytes was measured by flow cytometry. Granulocyte percentage, C-reactive protein, interleukin-6 (IL-6). Results There was no significant difference in the ratio of CD3 +, CD4 +, CD8 +, CD4 + / CD8 + between the ultrasonic knife group and the electric knife group (P> 0.05). The mean intraoperative blood loss, abdominal operation time, perineal operation time, h drainage volume, white blood cell count, granulocyte percentage, C-reactive protein, IL-6, ultrasonic knife group were significantly reduced, the difference was statistically significant (P <0.05). Conclusions There is no significant difference between the two surgical approaches in Miles operation and the postoperative immune function. However, the ultrasonographic knife group recovered quickly and had less postoperative stress response, which is worthy of clinical application.