摘要
目的:探讨不同的手术治疗方式对胆囊癌术后疗效及血清炎症因子、T淋巴细胞亚群水平的影响。方法:选择2020年1月—2023年3月西安交通大学第一附属医院收治的胆囊癌患者96例,按照随机数字表法分成对照组和研究组,每组48例,对照组采用开腹胆囊癌根治术,研究组采用腹腔镜胆囊癌根治术,比较两组术前和术后7 d血清炎症因子[白细胞介素(IL)-6、IL-8、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)]水平、T淋巴细胞亚群(CD3^(+)、CD4^(+)、CD8^(+))水平、围手术期相关指标(肠功能恢复时间、手术时间、术中出血量、住院时间)、并发症发生率及复发率和死亡率。结果:术前,两组IL-6、IL-8、CRP、TNF-α水平差异无统计学意义(P>0.05);与术前相比,术后7 d两组IL-6、IL-8、CRP、TNF-α水平均升高,且研究组低于对照组,差异有统计学意义(P<0.05)。术前,两组CD3^(+)、CD4^(+)、CD8^(+)差异无统计学意义(P>0.05);与术前相比,两组术后7 d的CD3^(+)、CD4^(+)、CD8^(+)水平均降低,且研究组高于对照组,差异有统计学意义(P<0.05);研究组肠功能恢复时间、手术时间、术中出血量、住院时间均少于对照组(P<0.05)。研究组术后并发症发生率低于对照组(2.08%比14.58%),差异有统计学意义(P<0.05)。两组术后1年内的复发率及死亡率差异无统计学意义(P>0.05)。结论:腹腔镜胆囊癌根治术可明显改善胆囊癌患者炎症因子水平,降低术后并发症发生的风险,且安全性高。
Objective:To explore the effects of different surgical treatment methods on postoperative efficacy,serum inflammatory factors,and T lymphocyte subsets levels in patients with gallbladder cancer.Methods:96 patients with gallbladder cancer admitted to the First Affiliated Hospital of Xi'an Jiaotong University from January 2020 to March 2023 were randomly divided into a control group and a study group,with 48 patients in each group.The control group underwent open cholecystectomy,while the study group underwent laparoscopic cholecystectomy.The levels of serum inflammatory factors(IL-6,IL-8,CRP,TNF-α),T lymphocyte subsets(CD3^(+),CD4^(+),CD8^(+)),perioperative indicators(intestinal function recovery time,surgery time,intraoperative bleeding,hospital stay),incidence of complications,recurrence rate,and mortality rate were compared between the two groups before and 7 days after surgery.Results:Before surgery,there was no statistically significant difference in the levels of IL-6,IL-8,CRP,and TNF-αbetween the two groups(P>0.05);Compared with preoperative levels,the levels of IL-6,IL-8,CRP,and TNF-αin both groups increased 7 days after surgery,and the study group was lower than the control group,with statistical significance(P<0.05).Before surgery,there was no statistically significant difference in CD3^(+),CD4^(+),and CD8^(+)between the two groups(P>0.05);Compared with preoperative levels,the levels of CD3^(+),CD4^(+),and CD8^(+)in both groups decreased 7 days after surgery,and the study group was higher than the control group,with statistical significance(P<0.05);The recovery time of intestinal function,surgical time,intraoperative blood loss,and hospital stay in the study group were all shorter than those in the control group(P<0.05).The incidence of postoperative complications in the study group was lower than that in the control group(2.08%vs 14.58%),and the difference was statistically significant(P<0.05).There was no statistically significant difference in recurrence and mortality rates between the two groups within one year after surgery(P>0.05).Conclusion:Laparoscopic radical cholecystectomy can significantly improve the levels of inflammatory factors in patients with gallbladder cancer,reduce the risk of postoperative complications,and has high safety.
作者
谭文君
邢斌瑜
朱皓阳
俞兆坤
李希
王文静
TAN Wen-jun;XING Bin-yu;ZHU Hao-yang;YU Zhao-kun;LI Xi;WANG Wen-jing(Department of Surgical Intensive Care Medicine,First Affiliated Hospital of Xi'an Jiaotong University.Xi'an 710061,China;Department of Anesthesiology,First Affiliated Hospital of Xi'an Jiaotong University.Xi'an 710061,China)
出处
《中国现代普通外科进展》
CAS
2024年第11期852-855,共4页
Chinese Journal of Current Advances in General Surgery
基金
陕西省自然科学基础研究计划一般项目[(青年(2023-JC-QN-0898)]。
关键词
腹腔镜手术
胆囊癌
血清炎症因子
T淋巴细胞亚群
复发率
死亡率
Laparoscopic surgery
Gallbladder
Serum inflammatory factor
T lymphocyte subsets
Recurrence rate
Mortality
