摘要
目的研究胃癌患者行腹腔镜根治术后氧化应激反应及内生化环境的变化情况。方法回顾性分析2017年7月至2018年7月在志丹县人民医院实施腹腔镜根治术的74例胃癌患者的临床资料,按照不同手术方法分为对照组和观察组,每组37例,对照组行开腹手术治疗,观察组行腹腔镜根治术,比较两组患者术前、术后即刻和术后1 d、3 d不同时点血清氧化应激反应指标[氧化物歧化酶(SOD)、丙二醛(MDA)]、免疫功能[CD3+、CD4+/CD8+]、血乳酸、电解质[钾离子(K+)、氯离子(Cl-)]水平的差异。结果术后即刻,两组患者的SOD水平明显低于术前和术后1 d、3 d,MDA水平明显高于术前和术后1 d、3 d,差异均有统计学意义(P<0.05),且术后即刻、术后1 d,观察组患者的SOD水平明显高于对照组,术后即刻、术后1 d、3 d,MDA水平明显高于对照组,差异均有统计学意义(P<0.05);术后即刻,两组患者的CD3+、CD4+/CD8+水平低于术前和术后1 d,差异均有统计学意义(P<0.05),且术后即刻、术后1 d,观察组患者的CD3+、CD4+/CD8+水平明显高于对照组,差异均有统计学意义(P<0.05);观察组患者术后即刻的血乳酸水平明显高于术前和术后1 d,差异有统计学意义(P<0.05),且术后即刻、术后1 d、3 d,观察组患者的血乳酸水平高于对照组,差异均有统计学意义(P<0.05);观察组患者术后即刻的Cl-水平低于术前和术后3 d,差异有统计学意义(P<0.05),且术后即刻,观察组患者的K+、Cl-水平高于对照组,差异均有统计学意义(P<0.05)。结论行腹腔镜根治术胃癌患者,手术结束后早期氧化应激反应最强、免疫功能最低、乳酸水平最高,电解质水平波动最强,但随着术后时间的延长,逐渐恢复正常水平。
Objective To study the changes of oxidative stress and endogenous environment in patients with gastric cancer after laparoscopic radical gastrectomy.Methods The clinical data of 74 patients with gastric cancer were retrospectively analyzed,who underwent laparoscopic radical gastrectomy in Zhidan County People's Hospital from July 2017 to July 2018.According to different surgical methods,they were divided into control group and observation group,with 37 cases in each group.The control group underwent laparotomy,while the observation group underwent laparoscopic radical gastrectomy.The serum oxidative stress indicators including superoxide dismutase(SOD)and malondialdehyde(MDA),as well as immune function indexes(CD3+,CD4+/CD8+),the levels of blood lactate and electrolyte(K+,Cl-),were compared between the two groups at different time points(before surgery,immediately after surgery,and 1 day and 3 days after surgery).Results The SOD levels in the two groups were significantly lower immediately after surgery than before and after 1 day and 3 days of operation;while the MDA levels in both groups were significantly higher immediately after surgery than before and after 1 day and 3 days of surgery(P<0.05).The SOD levels immediately after surgery and 1 day after surgery were significantly higher in the observation group than in the control group,while the MDA levels immediately after surgery,1 day and 3 days after surgery were significantly higher in the observation group than in the control group(P<0.05).The CD3+levels and CD4+/CD8+ratio in both groups were lower immediately after surgery than before and 1 day after surgery(P<0.05);and the CD3+levels and CD4+/CD8+ratio immediately after surgery and 1 day after surgery were significantly higher in the observation group than in the control group(P<0.05).The blood lactate level in the observation group was significantly higher immediately after surgery than before surgery and 1 day after surgery(P<0.05),and the blood lactate levels immediately after surgery,1 day and 3 days after surgery were significantly higher in the observation group than in the control group(P<0.05).The Cl-level in the observation group was lower immediately after operation than before operation and 3 days after operation(P<0.05);and the levels of K+and Climmediately after operation were higher in the observation group than in the control group(P<0.05).Conclusion For patients with gastric cancer who underwent laparoscopic radical gastrectomy,the oxidative stress is the strongest at the early stage after surgery,with the lowest immune function,the highest blood lactate level,and the strongest fluctuation in electrolyte levels.However,these indicators gradually return to normal levels with the prolongation of postoperative time.
作者
胡佐宇
崔正旅
HU Zuo-yu;CUI Zheng-lv(Department of General Surgery,Zhidan County People's Hospital,Yan'an 717500,Shaanxi,CHINA)
出处
《海南医学》
CAS
2019年第18期2353-2356,共4页
Hainan Medical Journal
关键词
胃癌
腹腔镜
胃癌根治术
氧化应激反应
内生化环境
Gastric cancer
Laparoscope
Radical gastrectomy
Oxidative stress
Endogenous environment
