摘要
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 discuss the influence of ultracision versus electrotome on the immune function and stress reaction in patients at er rectal cancer Miles operation. Methods A retrospective analysis was performed on 82 rectal cancer patients who received Miles operation between February 2007 and August 2012. Among them, 45 accepted ultracision, and 37 received electrotome operation. We compared the two groups in terms of abdominal and perineum surgery time, blood loss volume, drainage volume within 72 hours after operation, and analyzed the CD3＋, CD4＋, CD8＋, CD4＋/CD8＋ ratio by l ow cytometry before and at er operation. In addition, we tested the white blood cell count, percentage of granulocyte, C-reaction protein（CRP）, and interleukin（IL）-6 three days at er operation. Results h ere was no obvious dif erence in CD3＋, CD4＋, CD8＋, CD4＋/CD8＋ ratio between the two groups. However, the incidence of blood loss volume, abdominal operation time, perineum operation time, drainage volume within 72 hours at er operation, white blood cell count, percentage of granulocyte, CRP, IL-6 in the ultracision group was dramatically lower compared with the electrotome group（P〈0.05）. Conclusions h ere is no signii cant dif erence in the inl uence on the immune function between the two kinds of operation methods, but ultracision can achieve faster recovery and smaller stress reaction at er operation. It is worthy of clinical popularization.
出处
《华西医学》
CAS
2015年第12期2238-2241,共4页
West China Medical Journal
关键词
直肠肿瘤
免疫活性应激
超声刀
电刀
Rectal cancer
Immune active stress
Ultracision
Electrotome
