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目的探讨全腔镜D_2根治术与开腹D_2根治术治疗远端胃癌患者疗效及对免疫功能的影响。方法选取2011年6月至2013年5月间河北医科大学附属第四医院收治的148例远端胃癌患者,采用随机数字表法分为干预组和对照组,每组74例。干预组患者采用全腔镜D_2根治术,对照组患者采用开腹D_2根治术,观察两组患者治疗后相关疗效指标和免疫功能指标。结果干预组和对照组患者术中出血量分别为(293.7±115.2)ml和(314.3±135.5)ml,两组比较,差异有统计学意义(P<0.05);干预组和对照组患者术后住院时间分别为(9.38±2.6)h和(13.46±3.2)h,两组比较,差异有统计学意义(P<0.05);术后3周,干预组和对照组患者NK分别为(27.6±8.3)%和(19.7±8.2)%,两组比较,差异有统计学意义(P<0.05);术后3周,干预组和对照组患者CD3+、CD4+分别为(62.5±7.6)%、(54.1±5.9)%、(47.5±6.5)%和(45.6±7.1)%,两组比较,差异均有统计学意义(均P<0.05)。结论全腔镜D_2根治术对患者免疫功能影响小、术后恢复快,治疗远端胃癌疗效显著。
Objective To investigate the effect of total endoscopic D 2 radical mastectomy and open radical D 2 radical mastectomy on patients with distal gastric cancer and its influence on immune function. Methods A total of 148 patients with distal gastric cancer admitted to the Fourth Affiliated Hospital of Hebei Medical University from June 2011 to May 2013 were randomly divided into intervention group and control group with 74 cases in each group. The patients in the intervention group were treated with endoscopic D 2 radical mastectomy. The control group received radical d 2 laparoscopic radical mastectomy. The curative effect and immune function of the two groups were observed. Results The mean amount of bleeding in intervention group and control group was (293.7 ± 115.2) ml and (314.3 ± 135.5) ml, respectively, with significant difference between the two groups (P <0.05) The hospital stay was (9.38 ± 2.6) h and (13.46 ± 3.2) h, respectively, with significant difference between the two groups (P <0.05). At 3 weeks after operation, NK in intervention group and control group were (27.6 ± (P <0.05). The levels of CD3 + and CD4 + in the intervention group and the control group were (62.5 ± 7.6)% and 54.1 ± 5.9)%, (47.5 ± 6.5)% and (45.6 ± 7.1)%, respectively. There were significant differences between the two groups (all P <0.05). Conclusions Total endoscopic D 2 radical surgery has little effect on immune function and rapid recovery after operation. The treatment effect of distal gastric cancer is remarkable.